New Resource Available: Toolkit: Understanding and Responding to CMS’s Proposed GEMT Rule.
CMS has released a proposed rule that could significantly reshape the future of Ground Emergency Medical Transportation (GEMT) supplemental reimbursement programs nationwide.
For the first time, CMS is proposing provider-specific payment limits for certain targeted Medicaid supplemental payments, specifically identifying GEMT providers, air ambulance providers, and NEMT providers. If finalized as written, the proposal could affect future reimbursement methods, supplemental payment structures, State Plan Amendments, and the long-term sustainability of many Medicaid financing programs.
To help EMS leaders better understand, and respond to the proposal and its potential impact, the PWW Advisory Group team has created a Toolkit featuring educational materials, advocacy tools, and practical guidance. Inside you’ll find:
- Guide to Terms and Concept
- Summary of State GEMT Program Descriptions and Potential CMS Proposed Rule Risk
- The CMS Proposed Rule with Highlights of Language Potentially Impacting GEMT Programs
- Talking Points: Explaining the Potential Local Impact of the CMS Proposed Rule
- Talking Points to Elected Officials: The Potential Local Impact of the CMS Proposed GEMT Rule
- [Editable] Example Agency Letter to CMS on Proposed Rule (with link to send submission)
- [Editable] Example State-National EMS Association Letter to CMS on Proposed Rule (with link to send submission)
The proposal was a major topic of discussion during PWW|AG President Doug Wolfberg‘s Medicare and Reimbursement Update at abc360 conference in Clearwater Beach in June. During his session, Doug noted that if finalized, the rule could limit Medicaid GEMT supplemental payments to Medicare reimbursement levels, potentially creating significant financial implications for some participating public EMS agencies.
The proposal remains open for public comment period, and we encourage EMS leaders to review the rule and consider how it could affect their organizations and communities.
As always, the PWW|AG team will continue analyzing the proposal, developing additional resources, and sharing practical guidance as the rulemaking process moves forward. If you want to find out more about how this will impact your organization directly, or what you should be doing next, get in touch with our experts here.
