New CMS Rule Threatens to Gut GEMT Funding for EMS Agencies Nationwide

CMS Proposed Rule Threatens GEMT Funding for EMS Agencies

What the Proposed Rule Would Do

CMS released a proposed rule on May 20 (CMS-2449-P) that could hit GEMT programs hard. The rule caps Medicaid supplemental payments, including GEMT, air ambulance, and NEMT, at Medicare Ambulance Fee Schedule rates starting in 2029, with existing payments phased down starting in 2028. That will impact EMS agencies and fire departments across the country because most GEMT programs are built on cost-reconciliation or ACR-style formulas that pay well above Medicare rates. While NAEMT disagrees, CMS’s stated goal is cracking down on financing schemes it sees as gaming the system rather than improving care.

Why This Threatens EMS and Fire Department Readiness

GEMT supplemental payments are often what keeps public and rural EMS agencies afloat since Medicare rates alone do not cover the real cost of a 911 response. NAEMT is concerned that capping the funding at Medicare levels, EMS agencies and fire departments across the country, specifically in rural areas could be facing a serious funding gap. The proposed rule will unnecessarily jeopardize our nation’s readiness to respond to medical emergencies and other critical incidents. Rather than reducing these already incomplete reimbursements.

NAEMT Joins Opposition to the Rule

NAEMT joined 17 other organizations in a comment letter opposing CMS’ proposed rule expressing deep concern that this proposal will eliminate critical funding for our nation’s EMS agencies and fire departments and urged CMS to support policy options that would enable our members to treat patients more efficiently, both medically and financially.

You can view the letter here.
You can read the complete CMS release here.