The Iowa GEMT cost report is mostly a documentation exercise. If the source records are clean and complete, the report builds itself. If they’re not, the report becomes a multi-week archaeology project.

Use the checklist below as an intake list — what to pull together before you start building schedules.

Eligibility and authorization

  • Provider Participation Agreement (Iowa Form 470-0087) signed for the relevant state fiscal year
  • Iowa Medicaid provider enrollment confirmed for the entire reporting period
  • Intergovernmental transfer (IGT) agreement executed and current
  • Authorized signatory identified — the person who will certify the report

Personnel records

  • Payroll detail by employee for the full state fiscal year (July 1 – June 30)
  • Hours by employee broken into transport vs. non-transport activity
  • Benefit costs (FICA, retirement, health insurance, workers’ comp) by employee
  • Overtime and standby compensation detail
  • Volunteer hours and any associated stipends (if applicable)

Run / transport data

  • Total responses for the period
  • Total transports for the period
  • GEMT-eligible Medicaid transports — emergency ground transports of Iowa Medicaid members
  • CAD or ePCR exports that support the transport counts
  • Reconciliation of internal transport counts to the Iowa Medicaid Management Information System (MMIS) record

Financials

  • Audited (or compiled) financial statements for the period
  • General ledger detail for all transport-related accounts
  • Revenue by payer (Medicare, Medicaid, commercial, self-pay, contract)
  • Any subsidies, levies, or appropriations from the parent jurisdiction

Capital and equipment

  • Depreciation schedule for ambulances
  • Depreciation schedule for stations and facilities
  • Depreciation schedule for medical and communications equipment
  • Lease agreements for vehicles or facilities (if any)
  • Capital purchases during the period with invoices and useful-life assumptions

Indirect costs

  • Established indirect cost rate documentation
  • Source: Cost Allocation Plan from the parent jurisdiction, or negotiated rate with the cognizant federal agency
  • Methodology consistent with 45 CFR 75.412
  • Schedule of indirect cost pools and bases

Shared-resource allocations

  • Allocation methodology for any shared resources (e.g., a station shared with fire suppression)
  • Time-study or square-footage documentation supporting the allocation
  • Consistency check: same direct/indirect classification across every schedule

Supplier and vendor records

  • Vendor invoices for major non-personnel expenses
  • Insurance schedules (general liability, vehicle, professional)
  • Fuel and maintenance records
  • Medical supply purchase detail

Final review

  • Cross-check totals on each schedule against source records
  • Reconcile reported transports to MMIS
  • Authorized official reviews and certifies
  • Submit to costaudit@hhs.iowa.gov before November 30
  • Keep a complete copy of the submitted report and all source documents for audit

The cost report is not where you do your accounting. It’s where you document accounting that has already happened. If the source records aren’t ready, the cost report can’t be either.