There has been much discussion about the future of Ground Emergency Medical Transport (GEMT) programs since the Centers for Medicare and Medicaid (CMS), Office of the Inspector General (OIG) announced audits of GEMT program in 2023, following a memo from CMS to state Medicaid Directors in 2022 (see the link below to see the memo).

The most recent GEMT reimbursement allocations in Texas may provide insight into the future direction of GEMT programs across states that currently have these programs, and those who have pending applications for Medicaid State Plan Amendments with CMS.

PWW Advisory Group has done a deep dive into the changes in the Texas GEMT program, including what the changes were, and how the Federal Settlement Amounts and distribution of GEMT funds based on revised cost and revenue reporting methodology, and the impact on GEMT reimbursements to participating agencies.

Could this new model be an example of changes coming to all GEMT programs? 

Read the full analysis here: 

PWWAG Assessment - Texas GEMT Program 2023 vs 2022.pdf

Informational summary data tables:

2022 CMS memo to State Medicaid Directors on GEMT cost allocation:

Highlighted - CMS Memo on Cost Allocation for GEMT - 8-17-22.pdf