Paving the Path to Medicare GADCS Compliance
By Sarah DiCicco, MBA*
What is the Medicare Ground Ambulance Data Collection Survey (GADCS)?
The Medicare GADCS is a one-time requirement established by the Centers for Medicare and Medicaid Services (CMS) that mandates all providers of ground ambulance transportation to report department statistics such as expenditures, utilization, and revenue. Roughly 10,000 agencies were selected to report into the survey over four separate selection years. Due to the public health emergency in 2020, the program start date was delayed, however the overall program is still on track to end with CMS announcing results and potential reformation in 2026.
Why Should My Organization Comply?
If a selected organization does not comply, then that organization will face a 10 percent reduction in Medicare Part B payments for one full calendar year. Additionally, if CMS does not receive adequate participation from organizations, then we may not expect to see any reform to current Medicare payment rates.
Roughly half of all providers selected for participation must report into the survey in 2023, with the first few submission rounds already completed. Public Consulting Group LLC (PCG) partnered with dozens of providers to comply with this requirement by the May 31st deadline, in which we gathered insight on how serious CMS is regarding compliance with this survey.
- Notification emails were sent to organizations that missed their submission deadline and 30-day extensions were offered to increase compliance.
- CMS’ partner, the RAND Corporation, began assessing survey submissions and inquired with organizations where survey answers contained outliers.
- CMS has granted organizations the opportunity to adjust their data collection period on a case-by-case basis.
Based on these actions, we see that CMS is accurately assessing Medicare GADCS submissions and will enforce the penalty for non-compliance. We also know that CMS requires sufficient data to make an informed decision as to whether Medicare payment rates should be adjusted if annual reporting will become a requirement for agencies across the country, or if there is another measure that will be enforced in the future.
How Can My Organization Comply?
The chart below outlines a few key steps that your organization can complete in order to maintain compliance with CMS’ Medicare GADCS.
| Know your organization’s selection year | Each of the four selection lists can be found here; given the delay in the program, Year 1 and Year 2 providers were required to begin data collection in 2022, and Year 3 and Year 4 providers were required to begin data collection in 2023. |
| Respond to the CMS Notification Letter | Enter your preferred data collection period and main point(s) of contact. |
| Understand your timeline | Mark your calendar with important check-ins related to data collection and data reporting to stay on track. |
| Data collection | Review data reports periodically to ensure that systems are capturing all necessary elements. |
| Connect with vendors | Collaborate with your CAD system contact or your billing vendor to ensure reports pull accurate data for the correct time period. |
| Register for the CMS web-based portal | Be sure to not delay with the registration process; here are steps for successful registration. |
How Does my Organization Select a Timeline?
Every selected organization has the option to report data for a 12-month continuous period based on either the calendar year or the organization’s fiscal year. We find most organizations select their fiscal year because it is easiest to report on financial data. Below outlines a high-level timeline to estimate the overall process of the Medicare GADCS.
What if My Organization Does Not Have Adequate Resources to Complete the Survey?
The Medicare GADCS has proven to be an interesting challenge for many agencies across the United States, with one main challenge being supported adequately to complete the requirements. Gathering the data is only one part of the equation, with the other being analyzing the data and reporting it into the CMS web-based portal.
PCG has bridged this gap for dozens of ground ambulance providers across the country. We limit the administrative burden on organizations so that ambulatory staff can continue to support departmental operations and their community to the best of their abilities. Whether your organization is looking for basic training, data templates, and quick guides to get you started or the full package, PCG is here to provide support.
We offer three levels of service based on your budget and needs. Our Medicare experts are available to provide one-on-one expertise, guidance, and clarity throughout all phases of the data collection and reporting process to ensure reports are completed accurately and consistently.
If you are interested in partnering with PCG or have additional questions related to the survey, you may view our services here and/or connect with one of our experts here.
*Sarah DiCicco is a healthcare consultant in Public Consulting Group’s (PCG) Austin, Texas office and is a member of the Financial Services Solutions (FSS) Center of Excellence. Ms. DiCicco joined PCG in 2020 and holds a Bachelor of Science in Business Administration from the University of San Francisco and earned an Executive Master of Business Administration degree from the University of Texas. As a Senior Consultant, she provides EMS reimbursement and claim solutions services to state and local governments and supports ambulance service providers in cost recovery and revenue maximization initiatives. Ms. DiCicco serves as a subject matter expert and drives the Medicare Ground Ambulance Data Collection effort for public and private providers. Sarah and her team are currently working with over 180 providers nationwide to accurately submit CMS’ Instruments. They understand the long-term impact this data will have on the EMS industry as well as the implications of inaccurate or incomplete submissions.
