What is the GEMT Program?
The Ground Emergency Medical Transportation (GEMT) Uncompensated Cost Reimbursement Program is a voluntary program that allows for the reimbursement of uncompensated costs to eligible GEMT providers who provide qualifying emergency ambulance services to MO HealthNet participants. Total reimbursement from the MO HealthNet Division (MHD), will not exceed 100% of the GEMT provider’s actual costs. Reimbursement shall be distributed to enrolled providers based on GEMT services provided to the participant on a per-transport basis.
Under this voluntary program, providers must agree to fund the non-federal share of GEMT uncompensated costs reimbursement using an intergovernmental transfer (IGT) payment method. The GEMT Program must be implemented without any additional expenditure from the state general fund. As a condition of participation under this program, an eligible provider must agree to reimburse MHD for administering and overseeing the GEMT program. GEMT Program authority is found in Section 208.1030 RSMo, 13 CSR 70-6.020; and State Plan Amendment 17-009.
Who can be a provider?
Provider participation in the GEMT Program is voluntary. Eligible providers must meet several requirements to participate in the GEMT Program, which include the following:
- Provide GEMT services to MO HealthNet participants;
- Be enrolled as a MO HealthNet Ambulance Program provider on or before July 1 of the reporting fiscal year; and
- Be owned or operated by the state or a political subdivision.
NOTE: Non-governmental providers may not participate in the GEMT Program.
How to Get Started
1
Register & Log In
- Ambulance Providers must register with the GEMT portal
- After you register, you will receive your log in information for Myers & Stauffer
2
Upload Documents
After you log in, you will need to upload the following documents to the GEMT portal:
3
Submit Cost Report
- Follow the instructions to complete your cost report
- Every year, providers must complete a cost report and submit to the portal by November 30 for the prior fiscal year ending June 30
How does reimbursement work?
GEMT providers eligible to participate in the GEMT Program may receive initial cost settlement payments based on the provider’s completed annual cost report and the provider’s average cost per transport. The GEMT provider will make an intergovernmental transfer of funds to MHD in an amount equivalent to the nonfederal share of the uncompensated Medicaid costs amount shown on the completed annual cost report. MHD will then make an initial payment to the GEMT provider in the amount of the total uncompensated Medicaid costs.
Within one (1) year of receipt of the as-filed cost report, MHD will make adjustments as necessary to the initial cost settlement based on the reconciliation results of the most recently retrieved Medicaid Managed Information Systems (MMIS) report of paid GEMT transports, unless MHD determines that additional time is needed. The reconciliation process will not exceed three (3) years from the receipt of the as-filed cost reports.
If at the end of the final reconciliation it is determined the GEMT provider has been overpaid, the provider will be required to return the overpayment to the MHD and the MHD will return the overpayment to the federal government. If an underpayment is determined, then the GEMT provider is to make an additional intergovernmental transfer to MHD in an amount equivalent to the nonfederal share of the underpayment, and MHD will then make an additional payment to the GEMT provider of the full underpayment amount.
Questions?
Questions regarding the Myers and Stauffer portal should be directed to 1-800-374-6858. Questions about the GEMT Program should be directed to 573-526-4368 or to Ask.GEMT@dss.mo.gov.