EMS COVID-19 Update Newsletter to FFCA

EMS COVID-19 IMPACT FFCA and PCG Partnership



We want to start off this newsletter by thanking you and the entire ambulance provider community for your service during the COVID-19 pandemic. We know that the crisis has presented many of you with unique personal and professional challenges, and we want you to know how much you are appreciated, now and always. If there is anything that we at PCG can do to support you at this time, please do not hesitate to reach out.

With certain revenue sources declining and costs continuing to rise, it is as important as ever to be aware of all funding opportunities for your agency. Our goal is to provide you with a brief overview of what we know now. Please keep in mind that relief funding will evolve as the crisis continues.



Many of you are already participating in supplemental payment programs for Medicaid. These cost reporting programs continue to roll on with minimal interruptions through the COVID-19 crisis. While we have seen some deadline extensions for cost report submission in several states, we have not yet seen any significant delays in payments. Due to resource constraints, there are, however, some states that have temporarily delayed implementation of new programs. Still, we are encouraged that this funding source remains viable for many of you.

New EMS supplemental payment programs are being implemented each year. We recently received the exciting news that the Centers for Medicare and Medicaid Services (CMS) approved the Florida Public Emergency Medical Transportation (PEMT) Managed Care Organization (MCO) Program. This program will consist of a net of up to nearly $34 million in new federal dollars available. The approval of this MCO supplemental payment program also sets the precedent for similar programs in other states that have a higher proportion of Medicaid under managed care, rather than the traditional fee-for-service systems.


CMS issued a blanket waiver to modify the reporting period for first-year selectees for Ground Ambulance Cost Data Collection. In a May 15 release, CMS granted first-year selectees-that were due to collect data beginning between January 1, 2020, and December 31, 2020-the opportunity to select a new continuous 12-month data collection period that begins between January 1, 2021, and December 31, 2021. This change was made in order to provide some flexibility to ambulance services so that they could focus on their operations and patient care during the current crisis. 

While the reporting of cost data to CMS was delayed for one year, providers should still be preparing for this process. It will be important that providers are tracking lost revenues and identifying additional expenses related to the COVID-19 emergency. This information will need to be tracked and reported so that CMS can identify the true costs of patient care and, additionally, so that agencies can utilize this data in future COVID-related funding opportunities. From an operations perspective, this means that your front-line personnel should be clearly documenting all COVID-suspected and COVID-positive cases and, as feasible, the additional cost of PPE and other supplies and time for caring for these patients.


On March 27, 2020, the President signed the Coronavirus Aid, Relief, and Economic Security Act (also known as CARES) that provides $100 billion to hospitals and other healthcare providers and suppliers, including ambulance services. Below is a breakdown of how the funding is being allocated.


  • The initial $30 billion was distributed to providers almost immediately. If your agency received Medicare fee-for-service (FFS) payments in 2019, you should have received your allocated funding via direct deposit by April 17, 2020. According to the payment formula, providers were to be distributed a portion of the $30 billion based on their share of the total Medicare FFS payments in 2019. Total Medicare FFS payments were approximately $484 billion in 2019.

To estimate what you should have received, you can plug in your 2019 Medicare FFS payments into the following formula:

[Your share of relief funding] = [ (Your Medicare FFS claims in 2019) / $484,000,000,000) * $30,000,000,000]

  • By June 3, 2020, providers are required to accept the HHS Terms and Conditions and submit revenue information to be considered for additional payments from the general distribution. 
    • Confirm receipt of previous funds on the CARES Act Provider Relief Fund Payment Attestation Portal, including agreeing to the Terms and Conditions
    • The remaining $20 billion of the general distribution is being disbursed based on a formula tied to net patient revenues. Providers should calculate 2018 net patient revenues [gross revenues (charges) less allowances and discounts (bad debt, contractual adjustments, charity care, etc.)] and enter this amount in the HHS portal. Submit your revenue information to the General Distribution Portal for consideration to receive additional general distribution funds.


Just as it is important to document COVID-presumptive and COVID-positive cases for Medicare cost data collection, there is also an immediate funding opportunity for uninsured that warrants a solid documentation trail. Starting April 27, 2020, ambulance services were allowed to register here to receive COVID-related payments for uninsured. Eligible claims are being reimbursed at the Medicare rate, and no balance billing is allowed on these claims.

Additional targeted allocations were made for COVID-19 high-impact areas ($12 billion), rural providers ($10 billion), and Indian Health Services ($400 million). More information about CARES Act Provider Relief Funding can be found here.


Under the Public Assistance Grant Program, state, local, tribal and territorial government entities, and certain private nonprofit organizations are eligible to apply to the Federal Emergency Management Agency (FEMA) for reimbursement of emergency protective measures taken to respond to the COVID-19 emergency. 911 and emergency medical services (EMS) agencies (including fire service, third government service, and certain private nonprofit services) may be reimbursed for certain costs related to the COVID-19 response.

Costs covered under this program include emergency medical care of COVID-19 patients, emergency operations centers, facilities, meals, medical supplies, medical testing vaccination, PPE, responder housing, staffing, and training. FEMA assistance will be provided at 75 percent federal cost share. Costs must be documented appropriately and submitted to FEMA to receive these grant funds.


Share this post:

Comments on "EMS COVID-19 Update Newsletter to FFCA"

Comments 0-5 of 0

Please login to comment