REMINDER: Join us for the info session Wednesday at 10am ET! Details below. Please share this with all relevant leaders in your organization.
Dear Massachusetts Ambulance Association members,
As a result of tireless advocacy by the Massachusetts Ambulance Association board and lobbyists, MassHealth is preparing to implement an assessment and supplemental payment program that we’ve been referring to as the “Medicaid Match Program.” We are proud to share that providers representing 95%+ of the non-governmental EMS transports in the Commonwealth have expressed support for this initiative, which promises to significantly supplement funding for mobile healthcare today and into the future.
While MassHealth is still waiting for final approval from CMS for this program, it is very likely that the first payments will be made in January (THIS MONTH) and the assessment will be collected shortly after. This message serves to provide you with additional information about the timing and details of the program.
How Does MassHealth Calculate My Organization’s Payment?
The payments that will go to each private ambulance services provider will be based on providers’ volume of Medicaid fee-for-service payments relative to all Medicaid fee-for-service payments during the period of January 2021 through June 2021. It also depends on how much non-emergency you do because 70% of the supplemental payments will be based on all emergency and non-emergency Medicaid services and 30% will be for non-emergency services only.
In response to MAA feedback about the tight budgets of EMS agencies, MassHealth has agreed to make these payments in January before collecting the assessment. The assessment will be collected shortly after the payments are made depending on CMS approval. The assessment amount will be 6% of total net revenue (total revenue minus bad debt, chair car, and air ambulance service revenue) from your 2019 cost report. If your total net revenue from the 2019 cost report was $14 million, your quarterly assessment amount will be $210,000 (6% of $14 million, divided by four to get this quarterly amount).
As the contract providers signed with the Association states, all providers with a net gain (providers that received more in supplemental payments than they paid in assessment) from this program will be assessed fees of 30% of that net gain. These fees will be used to make payments to the few providers who had a net loss from the program (they paid more in the assessment than they received in Medicaid payments), as well as consulting and other costs of the Association.
After both payment and assessment have occurred, probably mid-to-late January, the Association will send notification to each provider that calculates their net gain (or loss). For those with a net gain, the notification will show the amount of the fee that will be transferred from their bank account (30% of their net gain). For providers with a net loss, no fees will be owed and the notification will show the amount of payment that the provider will receive from the Association pool. The Association’s accountant will then transfer the fee out (for those with a gain) or transfer payments in (for those with a loss).
1. Sometime in January 2022, MassHealth will make first-quarter payments to all eligible providers.
2. Soon after, and likely by the end of January, MassHealth will send invoices to collect the assessment from all providers.
3. After both payment and assessment have been completed, the Association will send notification to all providers showing their net gain (or loss) and the amount that will be transferred from (or to) each providers’ bank account.
Where and When Can I Ask Questions?
Join the Massachusetts Ambulance Association board as well as our experts from Sellers Dorsey for an interactive Information Session on January 5, 2022 from 10:00–11:30 ET.
MAA Medicaid Match Info Session
January 5, 2022 10:00–11:30 ET
Meeting ID: 703 615 4492
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Please reach out to firstname.lastname@example.org with any questions in the meantime.
Thank you for your continued support of MAA and its EMS advocacy initiatives! We are proud to serve the Commonwealth’s EMS providers.
The Massachusetts Ambulance Association Board