A meeting was held with staff members of the Division of Medical Assistance (DMA) and members of the NCAEMSA reimbursement committee.  The purpose of the meeting was to discuss issues related to Medicaid ambulance reimbursement and was held as a follow up to the previously held meeting on April 29, 2004. 

At the previous meeting, the committee expressed a need to evaluate the current Medicaid policy regarding out of county mileage.  The committee recommended that Medicaid adopt the Medicare policies, which reimburse all loaded patient miles.   The recommendation was made to update this current coverage policy based on the current reimbursement rates, with the long term goal of increasing the Medicaid's allowables to match the current Medicare Fee Schedule.  DMA had requested an average loaded patient mile per transport for the state of NC.   Jeff White, JAS, made a request via the NCEMS list serve for this information.  Jeff presented the report to Medicaid, with a total of 36 agencies reported, with an average of 12.339 loaded miles per transport. 

Medicaid policy staff announced that they had drafted an updated policy that will allow all EMS agencies to be reimbursed for loaded patient miles.  The process includes submitting this policy to the Physicians Advisory Group (PAG) during their July meeting.  The PAG will review and make recommendations to DMA, within an estimated time frame of 3 months.  Once the policy has been reviewed and approved by the PAG, DMA must publish the proposed policy for a comment period of 45 days before the policy may become effective. 

The committee thanked the staff of DMA for moving so quickly on this policy that will help to bring relief to the EMS agencies.  In addition, the committee requested that DMA provide the EMS agencies with specific information that may be necessary in achieving the long term goal of increased reimbursement to better align their fee structure with Medicare.  The committee recognized that this effort would be a more lengthy process but was willing to work with DMA to provide the necessary information to get this process started.

An additional issue was raised regarding the increased concern related to bariatric patients and the additional costs associated with transporting these patients.  The issue is currently being addressed at CMS to develop a method of reimbursement for these types of transports.

The meeting was adjourned.  The committee will plan to meet again in September/October when the PAG has made their recommendation on the policy.