The Missouri EMS Agent Corporation (MoEMSAC) is a non-for-profit entity, independent from the state of Missouri, and composed of ground ambulance association leaders and providers across the profession here in Missouri. Simply put, MoEMSAC consists of the people who promoted the Ambulance Reimbursement Allowance (ARA) as a new program in Missouri and are now leading ground ambulance service providers toward significant increases in their Medicaid reimbursement rates by working to ensure the state and all providers receive the maximum amount of revenue and no adverse impact from the new ARA assessment through a proper redistribution and federally compliant mechanism.
The MoEMSAC contractors and Board of Directors have created the formula and methodology by which the ground ambulance profession and its customers will receive enhanced Medicaid reimbursement from this new state assessment and prevent any adverse impact to providers resulting from the assessment.
Since the mid 1990’s many state’s Medicaid providers, including hospitals, skilled nursing facilities and pharmacies, have been expanding their federal matching revenues and enhancing their Medicaid reimbursement rates through the use of the Federal Reimbursement Allowance (FRA) program. Commonly referred to as “provider taxes,” a provider group may assess itself a fee, derive additional federal matching dollars from it and use that “new money” to provide services for the indigent through Medicaid.
Despite the scarcity of resources then and now, intense oversight and limitations of the program by the federal government and many stipulations about the uniformity and broad based nature of any assessment (i.e. a cap is currently set at a max of 6% of gross receipts), state’s have nonetheless thrived in enhancing Medicaid reimbursement rates through the various types of programs in over 40 states.
In Missouri, independent entities are also in place to manage their three programs and ensure all providers receive the maximum amount of revenue from the assessment, no adverse impact from the assessments and that all redistributions made assist the state in maintaining federal compliance. ARA will be Missouri’s fourth FRA based provider assessment program.
At the urging of a sizeable majority of ground ambulance providers in Missouri, the ARA was passed and signed into law in 2009 with the same intent as its three predecessors. The state has published regulations beginning the assessment and providers must now comply but also may maximize their participation and benefit from law and program.