KS EMS - Revenue Maximization Program

Update to KEMSA members Aug. 17, 2017

Leadership from the Kansas EMS Association (KEMSA), Mid-America Regional Council Emergency Rescue Committee (MARCER), and the Kansas State Association of Fire Chiefs (KSAFC) met with leaders from the Kansas Department of Health and Environment (KDHE) on August 17, 2017 to discuss House Bill 2079, which is the bill recently enacted into law concerning reimbursement for Medicaid ground emergency medical transportation services.

KDHE is ready to move this reimbursement project forward and is well underway in the next step of the process toward implementation.  The next step in the process is for KDHE to develop a request for proposal (RFP) to be published to hire a contractor to administer the reimbursement program.  This RFP could be published as soon as next month (September). At the closing of the RFP period, KDHE will select a contractor to assist in moving the project to the next step, which will be the approval from the Centers for Medicare and Medicaid Services (CMS). Once approval is obtained from CMS, then KDHE can move into the implementation phase.  The time frame for approval from CMS is unknown as there may be follow up questions from CMS to KDHE that will need to be answered before CMS decides on approval of the Kansas plan.

KEMSA is excited to see this project move forward and has offered assistance to KDHE as they move through the process.  KEMSA will provide the membership further information as the project progresses. Questions can be directed to Brandon Beck, KEMSA President at brandon@kemsa.org

Final Report - Jan. 23, 2017

Over the past year, KEMSA commissioned Public Consulting Group, Inc. (PCG) to conduct a feasibility study for a revenue maximization initiative for EMS providers serving the State of Kansas. The objective of the feasibility study was to provide KEMSA and other stakeholders, including Kansas Department of Health and Environment (KDHE), the opportunity to understand the potential outcomes the CMS-approved approaches to EMS revenue maximization would have in the State of Kansas. The study focused on three options – (1) Certified Public Expenditure (CPE), (2) Intergovernmental Transfers (IGTs), and (3) Provider Assessment – that can be utilized to increase Medicaid reimbursement for EMS providers.

Together, KEMSA and PCG engaged the EMS provider community in order to determine which program option is the best fit for the state’s EMS providers. KEMSA placed a strong emphasis on including all types of providers in the discussions surrounding this revenue maximization initiative. To this end, KEMSA formed a diverse task force from all six regions representing various models and sizes of ambulance providers. Services represented in the task force included fire-based, hospital-based, and third service ground and air EMS providers with a mix of public, private, volunteer, and nonprofit statuses.

In collaboration with the task force, PCG worked with providers and billing vendors to collect data pertinent to transports, paid claims data, cost data, and other relevant demographical information. Additionally, PCG worked with KDHE to obtain Medicaid paid claims data for each provider. Both data sets were used in the final analysis and modeling to determine the fiscal impact each initiative would have on EMS providers. The results of this analysis and modeling are detailed in the EMS Revenue Maximization Initiative Feasibility Study & Recommendations Report - DOWNLOAD THE REPORT HERE.

We look forward to presenting KDHE with our recommended approach and soliciting input for moving forward to successfully establish an EMS revenue maximization program. KEMSA will continue to seek collaboration with the entire provider community as we progress with this initiative. We want to thank you for your continued cooperation and support in these efforts.

Current Status and Plan Update - September 2016

Download the facts and our timeline here.

Information presented at the 2016 KEMSA Conference & Expo - August 2016

View the presentation slides here.

Data Request from KEMSA - 8/17/16

Times are challenging with budget cuts and funding issues for EMS services.  That is why the Kansas EMS Association (KEMSA) has invested time and money into looking for federal funds that we can utilize to help not only a few EMS services in Kansas, but as many as possible.  This topic of revenue maximization is not related to the topic of Medicaid Expansion, and versions of these federal programs have been adopted in several states including Missouri, Indiana, Texas, Massachusetts, California, Utah, and Louisiana with programs under development in Michigan, Washington, Oregon, and Oklahoma.

KEMSA, in collaboration with Medicaid reimbursement experts from Public Consulting Group (PCG), is conducting a feasibility study for this EMS revenue maximization initiative for Kansas’ ambulance services. This initiative would generate additional Medicaid revenues for the EMS community at no additional cost to Kansas’ taxpayers.

To support this effort, KEMSA has formed a task force of EMS personnel from around the state representing various models and sizes of ambulances services.  The task force was formed to ensure that as we evaluate the information coming in, that we seek to incorporate all the various aspects of EMS in Kansas.

But, we need your help! In order to determine the best approach, it is essential to obtain relevant transport and billing data from the provider community. Your support is critical, as the approach selected to most effectively solve Kansas’ unique EMS needs will depend on the accuracy and completeness of the data received from providers like you.

You can download a copy of the data request here for your convenience. Instructions on how to enter your data are included on the data request form. This is the same survey that some Kansas ambulance services have completed through a web link; but to make sure that all Kansas EMS agencies have gotten the survey we are providing it so that you can simply complete the document and email it to us at KSEMS@pcgus.com.  

Please note that you will need to provide data for TWO state fiscal years – 2014 & 2015. If you utilize an outside billing service many of them are aware of this survey and are prepared to assist you with completing the survey.

The deadline for submitting your data request is October 1, 2016. If you have any questions, please contact PCG at KSEMS@pcgus.com.

Thank you,
Brandon Beck
KEMSA President

Letter from KEMSA - 6/24/16

KEMSA, in collaboration with Medicaid reimbursement experts from Public Consulting Group (PCG), will be conducting a feasibility study for an EMS revenue maximization initiative for Kansas’ ambulance services. An EMS revenue maximization initiative would generate additional Medicaid revenues for the EMS community at no additional cost to taxpayers of the State of Kansas. This is made possible through leveraging an opportunity provided through the federal Centers for Medicare and Medicaid Services (CMS). About 10 states, including California, Texas, Louisiana and Massachusetts, are already taking advantage of this opportunity.

KEMSA is working closely with officials with the Kansas Department of Health and Environment (KDHE) to evaluate the best option for Kansas ambulance services. There are several different programs allowed under federal law and each option has its own variables that need to be evaluated. KEMSA, KDHE and PCG are well aware of the diversity of EMS services in Kansas based upon size of operation, model (county based, private, fire based, hospital etc.) and economic strength of the services. Making the determination of which federal program can best benefit Kansas EMS is not a simple black & white comparison.

KEMSA has formed a task force to assist with the evaluation of the information which PCG will develop and guide the final decision as to which federal program is best for Kansas.

The task force includes:

  • Brandon Beck (KEMSA President, Lyon County EMS/City of Emporia Fire, Region V)
  • Marvin VanBlaricon (KEMSA Vice President, Clay County EMS, Region IV)
  • Rod Pace (Chair of Region VI, Air Methods)
  • David Adams (hospital based, Via Christi/ Riley County, Region V)
  • Con Olson (private service, TECH)
  • Deb Brown (Haskell County EMS, Region II, super rural)
  • John Hultgren (Dickinson County EMS, KEMSA Administrator Society, Region IV)
  • Shane Pearson (KSFFA, Board of EMS, Salina FD)
  • Dave Johnston (Sedgwick County EMS, Region III)
  • Brad Mason (MARCER, Johnson County Med-Act)
  • Micky Webb (City Manager, Independence)
  • Kristi Brown (AMR)
  • Kerry McCue (Ellis County EMS, Region I)
  • Eric Voss (KEMTA, Region IV, Concordia FD)
  • Melissa Wangemann (Kansas Association of Counties)
  • Grant Helferich (ambulance billing)

KEMSA has selected a diverse task force to facilitate the development of a program that mutually benefits public, private, and volunteer services of a variety of sizes and locales.

In the coming weeks, KEMSA will be reaching out to ambulance services across the state to request the transport and billing data needed to develop EMS revenue maximization feasibility modeling. Your support is critical, as the approach selected to most effectively solve Kansas’ unique EMS needs will depend on the accuracy and completeness of the data received from providers.

Please monitor the progress of this effort using this website page and if you have questions, please feel free to contact KEMSA President Brandon Beck at brandon@kemsa.org.


More resources on this topic are on the right side of this page for your information. 

Meeting Notes

7/19/16 Task Force Conference Call  - Download the notes here.

Kansas Information

Background on Funding Programs

Background on CPE, IGT and FRA (Provider Tax) from different sources 

Other State Programs

Missouri FRA Program - download information here

Utah Provider Assessment (FRA) Program
(This program does not yet appear to have CMS approval.)
An EMS provider assessment was created by the 2015 Utah Legislature (S.B. 172) to supply State matching funds for enhanced Medicaid reimbursements. Ground ambulance patient transports have been increased from a base rate of $142.72 to $696.00 for a net increase of $553.28.

Washington State

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