Medi-Cal Reimbursement Opportunities for Public Transit

1. Medi-Cal ReimbursementOpportunities for Public Transit CalACT Spring 2014 Margaret Heath

2. Medi-Cal Reimbursement Opportunities Requirements - Getting Started • Research Medi-Cal non-emergency non-medical transportation (NENMT) to determine how many of the trips your program provides may qualify. • Learn what NENMT is from the prospective of Medi-Cal Administrative Activities (MAA). http://www.dhcs.ca.gov/provgovpart/Documents/ACLSS/CMAA/CMAA%20Manual%20Revised%202011.pdf

3. Medi-Cal Reimbursement Opportunities Activity D: Non-emergency non-medical transportation (NENMT). The term “non-medical” does not refer to the type of vehicle used, but to the condition of the transportation recipient. In contrast… “non-emergency, medical transportation” must be provided in ambulances or wheelchair vans, and be supported by a Treatment Authorization Request.

4. Medi-Cal Reimbursement Opportunities Non-Emergency, Non-Medical Transportation Non-Emergency, Medical Transportation

5. Medi-Cal Reimbursement Opportunities Question: How frequently does a trip provided by your transportation services fit this description? “Arranging and/or providing non-emergency, non-medical transportation of a Medi-Cal eligible person to Medi-Cal services, and when necessary, accompaniment by an attendant.”

6. Medi-Cal Reimbursement Opportunities Does your program provide transportation to: • Adult Day Healthcare Centers • Behavior Health Programs • Dialysis Treatment • To/From Nursing Homes

7. Medi-Cal Reimbursement Opportunities Medi-Cal Non-Emergency Non-Medical Transportation (NENMT) Reimbursement The actual cost of providing Medi-Cal Non-Emergency, Non-Medical Transportation may be charged for reimbursement through the Local Governmental Authority ‘s (LGA) MAA program. This is a source of revenue for both the LGA and the transportation provider to offset costs of NENMT

8. Medi-Cal Reimbursement Opportunities NENMT Costs Include: • Tokens • Taxi Fares • Mileage • Audited Trip Costs

9. Medi-Cal Reimbursement Opportunities 50 % The reimbursement Gold Coast Transit receives for NENMT Costs is … • 50% of Audited Trip Costs • In FY 12 our audited trip cost was $29.69/trip • (Reimbursement was for qualifying trips)

10. Medi-Cal Reimbursement Opportunities Locate your local LGA (Local Governmental Authority)

11. Medi-Cal Reimbursement Opportunities Your local LGA is here http://www.maa-tcm.com/content/lga-contact-information

12. Medi-Cal Reimbursement Opportunities

13. Medi-Cal Reimbursement Opportunities Strongly Recommended – • Patience • Learn the MAA acronyms/language • Be prepared to explain your current budget/operations in lay terms • Understand how your scheduling/reporting software works • Patience

14. Medi-Cal Reimbursement Opportunities MOA for MAA Claiming Revenue Compliance. Claiming Plan Approval Letter

16. Fixed Route Bus System • 1.85 million annual revenue miles • 3.6 million boardings in FY13 • ACCESS Paratransit Services • 462,927 annual revenue miles • 70,927 boardings in FY13

17. Medi-Cal Reimbursement Opportunities GCT’s paratransit is contracted out. Contract invoiced on a vehicle revenue hour (VRH) basis Cost per trip verified (CAFR)

18. Medi-Cal Reimbursement Opportunities • Patience. GCT’s first contact with the LGA was in October 2010. In FY 14 GCT successfully completed first reimbursement. • FY 2011/12 Paratransit Operating Budget: • $2,037,193 Expenses • $ 243,898 Revenues (On-Board/Local Support) (per GCT CAFR for FY ending June 30, 2012) • FY 12 reimbursement total added $96,217

19. Medi-Cal Reimbursement Opportunities Revenue may take awhile to be realized via reimbursement through the MAA MAA revenue WILL fluctuate. Recommend conservative MAA revenue forecasting.

20. Medi-Cal Reimbursement Opportunities

21. Thank you! Medi-Cal Reimbursement Opportunities Margaret Heath Paratransit & Special Projects Manager 301 E Third Street Oxnard, CA 93030 805.483.3959, ext 120