Quality Assurance Assessment Program

A QAAP is a process authorized by the Michigan Legislature that levies an assessment on an ambulance service to leverage additional federal dollars into the Medicaid program, allowing higher reimbursement rates to be paid when providing ambulance services to Medicaid recipients. Currently, nursing and long-term care facilities, HMOs, hospitals and community mental health plans utilize this program to increase their Medicaid payments.

A QAAP data request letter from the Michigan Department of Health and Human Services (MDHHS) has been mailed (dated January 18) to every ambulance service in Michigan. Revenue reports are due very quickly.

MAAS has developed a list of frequently asked questions below to assist you in filling out your data report.


What is a QAAP?

A process to levy an assessment on ambulance providers in order to draw down additional federal Medicaid dollars, allowing for higher reimbursement rates.


Who is required to pay the QAAP assessment?

Every licensed ambulance service in the State of Michigan must participate in the program.


Are air providers (rotocraft and fixed wing) included in the program?

Yes, all licensed ambulance services must participate.


Will there be winners and losers?

Yes, those with high numbers of Medicaid trips will be "winners" in the program. Those with low Medicaid (and/or high commercial insurance) trips will likely be "losers". However, the program is designed to limit the number of losers as much as possible.


 Will urban services gain at the expense of rural services?

No, many rural providers will gain based on their payer mix.


 Is there a new formula to calculate our tax and new Medicaid revenues?

Yes, once the State has received all revenue data.


How do we account for calls that become a Medicare or Medicaid payer after they have been reported?

It depends on the type of reporting you provide. The revenue may get reported in a subsequent reporting period.


Do I report charges or payments?

You report payments received. Depending on your accounting type, your calculation may vary.


Do we include other revenues in our report such as ambulance standby revenues or local government subsidy payments?

Yes, federal regulations require that a QAAP must apply to all related items and services within the class (ambulance service). MDHHS is in the process of developing further guidance to better address this question.


What happens if we don’t report or if I under-report data to the State of Michigan?

The State will calculate your QAAP for you. Your service QAAP will be calculated using 150% of the highest reported revenue for any ambulance service within your State Prosperity Region.


What if I have additional questions?

Please contact the MAAS office and we'll be happy to help you! You can also join us during one of our upcoming webinars. Registration information can be found here.