NCFPD approves participation in new ambulance transport reimbursement program

Joe Naiman

Village News Correspondent

The California Department of Health Care Services reimburses ambulance providers, including fire protection districts with paramedic service, who transport Medi-Cal patients. A May 23 North County Fire Protection District board action approved participation in a new program with a higher reimbursement amount.

The 5-0 vote authorized NCFPD participation in the Public Provider Ground Emergency Medical Transportation Intergovernmental Transfer (PP-GEMT-IGT) program. The fire protection and emergency medical services agency will now receive $1,065 for each transport of a patient who is enrolled in Medi‑Cal.

“That will allow for additional state funding to help fund the revenue gap from transport,” said NCFPD Fire Chief Keith McReynolds.

Advanced life support ambulances are based at NCFPD Station 1 (Ivy Street), Station 4 (Pala Mesa) and Station 5 (Bonsall). What is known as the “North Zone” has an automatic aid program where the closest available resource is deployed regardless of the city or fire district where the call for service is needed, and a basic life support ambulance owned and staffed by the North County Fire Protection District is based at the Vista Fire Department’s Station 6 off of East Vista Way.

In 2013, the North County Fire Protection District began participation in the Ground Emergency Medical Transportation Certified Public Expenditure program which provided additional funding to Medi-Cal patients. That program provided net revenue after expenses of $264,358 for fiscal year 2021-22.

Another state program, the Quality Assurance Fee, leverages federal funding which requires a non-federal match; all ambulance providers pay a $32 fee for each patient transport and a $220 add-on for Medi-Cal patients and the NCFPD net revenue was $90,828.

The PP-GEMT-IGT program replaces the two other state programs. For Medi‑Cal patients without Medi-Care, the program will add $946.92 onto the current $118 base to total $1,065 per transport. For dual benefit Medi‑Cal and Medi-Care patients, the PP-GEMT-IGT program will add $531 with Medi-Care adding an additional $415 to the $118 base payment to total $1,065. The new program requires all participating agencies to contribute funding to establish a revenue stream. The $369,707 NCFPD share of that funding for fiscal year 2022-23 is based on calendar year 2022 transport data.

NCFPD staff estimates that participation in the PP-GEMT-IGT program could provide an additional $795,520 of revenue for calendar year 2023.