Title
Recommendation to Authorize the City Manager to Make Overpayments to the State Department of Health Care Services Concerning the Ground Emergency Medical Transportation Program. (City Manager/Fire)
Body
To: Honorable Mayor and Members of the Alameda City Council
EXECUTIVE SUMMARY
The State Department of Health Care Services (DHSC) reimburses the City of Alameda (City) for medical transports of individuals who receive Medi-Cal benefits based on Cost Reports that the City submits annually to the DHSC. Due to an error in the methodology that the City used in fiscal years 2011/12 through 2014/15, the DHSC overpaid the City $508,737.03 and has now requested the overpayment to be returned. City staff agrees the City was overpaid and, because of the amount of the overpayment ($508,737.03), the City Manager is requesting City Council authority to make this payment. Additionally, prior to the methodology being corrected, other Cost Reports were submitted using the same methodology, therefore, the City Manager is requesting Council authority to make other overpayments if City staff agrees such overpayments are in order
BACKROUND
From time to time, the Alameda Fire Department is called upon to transport persons who are Medi-Cal patients for medical purposes. Under the State's Ground Emergency Medical Transportation (GEMT) Program, the City is eligible to be reimbursed for its costs to provide these services. To be reimbursed, the City prepares a "Cost Report" on a fiscal year basis that it submits to the State. DHCS then reimburses the City. The Cost Report, however, is subject to a State audit which typically is completed two years after the City has received its reimbursement. Based on that audit, the DHSC will make an additional payment to the City when there has been an underpayment or the City is obligated to return to the State any overpayment for services or other costs that the State has determined were not subject to reimbursement.
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