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Announcement of OIG Audit of GEMT Programs

23 Aug 2023 7:38 AM | Matt Zavadsky (Administrator)

When the Center for Medicaid sent the attached communication to state Medicaid offices last August, some of us opined that this would be a likely next step in the review of GEMT programs.

It will be very interesting to see which states they choose, the findings from the audits, and what they plan to do if they determine overpayments have been made for uncovered services?

We hope these reviews are done expeditiously, as several state plan amendment (SPA) applications for GEMT programs are being withheld by CMS, pending further review. These delays hurt ambulance providers who are under reimbursed by state Medicaid programs.



Audit of Ambulance Services Supplemental Payment Program

Some States have implemented uncompensated care payment programs that allow ambulance providers to receive supplemental payments for services provided to Medicaid beneficiaries and uninsured patients. We will conduct audits of selected States to determine whether the States' claims for Federal reimbursement for supplement payments to these providers complied with Federal and State requirements.

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