1 Expanding Florida PEMT to Include Managed Care Background As you know, expanding the FL PEMT program to include supplemental payments for Managed Medical Assistance (“MMA”)/Medicaid Managed Care Organization (“MCO”) transports requires AHCA to obtain CMS approval. We are now getting about $30,000,000 a year in new federal dollars each year for the emergency medical transport of Medicaid patients. This only captures about 20% of the potential federal reimbursement because we do not receive any funds for patients that are in the state’s Medicaid Managed Care programs. We have been pursuing various options to increase our reimbursement to approximately $120,000,000 to $150,000,000 by adding the managed care component. We are close. The next steps are very technical and requires some expertise in analyzing the data to answer questions from AHCA and the Federal CMS. We are partnering with the Public Consulting Group, PCG, who currently is assisting most of our members already with their local CPE paperwork, to help expedite the process of the next steps and to ensure that we get those next steps right. PCG needs our help in getting a few of our members who are participating in the CPE program to share their past three years’ worth of CPE data. PCG thinks they can have the final analysis done by January, but Eric is going to push them for December. Eric and Travis both have a great relationship with PCG’s lobbyist in Tallahassee and they both think that this partnership will be in the best interest of our members. AHCA will seek approval by submitting a CMS 42 CFR 438.6(c) preprint form also called “Preprint Form” (see attached.) This form is how CMS gives approval for initiatives pertaining to MMA/MCOs. Completing the 438.6(c) Completing the form includes the following steps: Step Task Input Needed 1. Have agreement to submit the Preprint Form Have AHCA agree that they will submit the Preprint Form Case showing need for/benefit from program 2. Make recommendations to AHCA for completion of 438.6(c) preprint form Present options to AHCA Identify viable payment methodologies and align with State Medicaid Strategic Goals