County to pursue reimbursements for ambulance service

BY CHUCK VANDENBERG
PCC EDITOR

LEE COUNTY – According to a Lee County Supervisor, county-owned Lee County EMS Ambulance service could be in line for up to $600,000 in reimbursements this year from a federally-backed system to help offset Medicaid costs for public EMS systems.

At Monday’s regular meeting of the Lee County Board, Supervisor Garry Seyb said he wanted to move forward with submitting information to the Ground Emergency Medical Transport program, a federal Medicaid program overseen by the Iowa Department of Human Services.

Public Consulting Group, out of Boston, is one firm that handles the reporting requirements for publicly owned ambulance services under the GEMT guidelines. The program is a federal program that provides for increased Medicaid reimbursements only to publicly owned operations.

The consulting firm typically charges 18% for the work and those come from the reimbursement revenues. However, since Lee County EMS is a member of the Iowa EMS Association, those fees are reduced by 50%.

Public Consulting would need to gather information from Bill Young, the former director of Lee County EMS when it was under his family’s ownership. But the county would pay the consulting group nothing if they can’t establish a reimbursement rate for the county under the program.

“It’s a no-brainer to go after that money. Why leave half a million dollars on the table?” Seyb said.

“I think rather than us as a board waiting until next year when we own the information, so to speak, it would behoove us to go ahead and contract with this group to see if we can get the information if it all exists,” Seyb said.

The county took ownership of the ambulance service on July 1, 2021. The information Public Consulting would be gathering, and potentially providing to the Iowa Department of Human Services, would set the supplemental reimbursement rates from that date through June 30, 2022.

Without that effort, the county wouldn’t be in line for the added revenue line.

Dennis Cosby said Public Consulting would like to have Lee County EMS on board by the end of October, and the assessment would need to be completed by the end of November. The county would then start billing the add-on rate to the program retroactive to July 1 if approved.

Cosby said he’s already contacted Young with a copy of the information needed and to explain what was going on.

“I would have no way of gathering that information. Without Bill, we will have to put this off to the following year,” he said.

Seyb said preliminary numbers would indicate the county could be in line for up to $600,000 in reimbursements.

“All those reimbursements we would be getting paid for would be based on services from last year. What’s sitting on the line is about $600,000,” he said Monday.

Supervisor Rick Larkin said it’s just another piece of a good system for the county.

“This is another example of a professional organization being put together for the ambulance service. People like this make us a better organization for ambulance service, so I’m really in favor of this,” said Supervisor Rick Larkin.

Currently, Burlington Fire Department is handling the billing for Lee County EMS. The cost of that service is also paid out of billable revenue at 6% of balances collected.

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