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HomeMy WebLinkAboutAgenda Item Summary FormAGENDA ITEM SUMMARY FORM File ID: #6444 Date: 11/26/2019 Commission Meeting Date: 12/12/2019 Requesting Department: Office of Management and Budget Sponsored By: District Impacted: All Type: Resolution Subject: MOU - Intergovernmental Transfer of Funds Purpose of Item: A resolution of the Miami City Commission, with attachment(s), authorizing the City of Miami ("City") to participate in and receive reimbursements under the new Medicaid Public Emergency Medical Transportation ("PEMT") and Managed Care Emergency Medical System ("EMS") Supplement Payment Program ("Partial Reimbursement Program") for Medicaid Managed Care ("MMC") patients transported by the City's Department of Fire -Rescue ("Department"), with administration of federal funds by the State of Florida ("State") through its Agency for Health Care Administration ("AHCA") for the first program year ending June 30, 2020 ("First Program Year"); authorizing the City Manager to negotiate and execute any and all necessary agreements, in a form acceptable to the City Attorney. Background of Item: The Department of Fire -Rescue (Department) transports two types of patients covered by Medicaid. Those that are enrolled in a Fee for Service (FFS) plans and those in enrolled in Medicaid Managed Care plans (MMC). Currently, the Department receives $190 for Advanced Life Support and $136 for Basic Life Support transports for both FFS and MMC patients. These payments are comprised of both a State of Florida share of 38.53 percent and a federal government share of 61.47 percent. Currently, the Department receives supplemental reimbursement for FFS transports from the Federal government through the Public Emergency Medical Transport (PEMT) Medicaid FFS program. In FY 2018-19 this program reimbursed an additional $2.343 million in revenues to the City of Miami. Therefore, paying a supplement in addition to the State share payment for the transport of FFS patients. In 2019, the Governor of the State of Florida (State) signed State Bill 2500 that established the PEMT MMC program to provide a reimbursement supplement to public transport providers for MMC patients. For MMC patients, federal rules 42 CFR 438.6 requires Florida to send its share of 38.53 percent of transport cost to the federal government by mean of an intergovernmental transfer (IGT). The IGT certifies the that public expenditures have been incurred. IGTs have been used from the beginning of the Medicaid program. The State established a funding pool of $54.000 million and requires that public emergency medical transportation provider send their state share portion of 38.53 percent as an intergovernmental transfer to State of Florida Agency for Health Care Administration (AHCA). AHCA will then leverage the State share portion in order to receive the 61.47 percent federal portion from the Centers for Medicaid and Medicaid Services (CMS) . CMS will then transfer back both the State and Federal share portions to AHCA. ACHA will then disburse funds to the various Managed Care Organizations (MCO) that currently reimburse the Department for transports. The MCOs will then reimburse the City based on the number of transports formula. This new program will pay a supplement above the fees that the City already is receiving. For the City to participate in the PEMT MMC program, ACHA requires each transport provider to sign a Letter of Agreement (LOA). This item is requesting the City Manager to be given the authority to sign a Letter of Agreement with AHCA and to allocate approximately $899,407 to be transferred to AHCA via and IGT. Budget Impact Analysis Item is Related to Revenue Item is an Expenditure Item is NOT funded by Bonds Total Fiscal Impact: The City expects to net $1.435 million in Federal share funds due to this new program. This includes $899,407 from Fire -Rescue's General Fund budget that will be sent to Agency for Health Care Administration and approximately $2.334 million of gross revenues received from both the Federal and State of Florida governments. General Account No: 00001.181000.881000.0000.00000 Office of Management and Budget City Manager's Office Legislative Division City Manager's Office Office of the City Attorney Office of the City Attorney City Commission Office of the Mayor Office of the City Clerk Office of the City Clerk Reviewed B Christopher M Rose Sandra Bridgeman Valentin J Alvarez Nikolas Pascual Barnaby L. Min Victoria Mendez Maricarmen Lopez Mayor's Office City Clerk's Office City Clerk's Office Department Head Review Assistant City Manager Review Legislative Division Review City Manager Review Deputy City Attorney Review Approved Form and Correctness Meeting Completed Completed Completed Completed Completed Completed Completed Unsigned by the Mayor Completed Signed and Attested by the City Clerk Completed Rendered Completed 12/02/2019 1:13 PM 12/02/2019 1:16 PM 12/02/2019 1:28 PM 12/02/2019 2:43 PM 12/02/2019 7:32 PM 12/02/2019 10:38 PM 12/12/2019 9:00 AM 12/23/2019 5:33 PM 12/23/2019 5:44 PM 12/23/2019 5:44 PM City of Miami Legislation Resolution Enactment Number: R-19-0512 City Hall 3500 Pan American Drive Miami, FL 33133 www.miamigov.com File Number: 6444 Final Action Date:12/12/2019 A RESOLUTION OF THE MIAMI CITY COMMISSION, WITH ATTACHMENT(S), AUTHORIZING THE CITY OF MIAMI ("CITY") TO PARTICIPATE IN AND RECEIVE REIMBURSEMENTS UNDER THE NEW MEDICAID PUBLIC EMERGENCY MEDICAL TRANSPORTATION AND MANAGED CARE EMERGENCY MEDICAL SYSTEM SUPPLEMENT PAYMENT PROGRAM ("PARTIAL REIMBURSEMENT PROGRAM") FOR MEDICAID MANAGED CARE PATIENTS TRANSPORTED BY THE CITY'S DEPARTMENT OF FIRE -RESCUE ("DEPARTMENT") WITH ADMINISTRATION OF FEDERAL FUNDS BY THE STATE OF FLORIDA ("STATE") THROUGH ITS AGENCY FOR HEALTH CARE ADMINISTRATION ("AHCA") FOR THE FIRST PROGRAM YEAR ENDING JUNE 30, 2020 ("FIRST PROGRAM YEAR"); AUTHORIZING THE CITY MANAGER TO NEGOTIATE AND EXECUTE ANY AND ALL NECESSARY AGREEMENTS, ALL IN A FORM ACCEPTABLE TO THE CITY ATTORNEY, IN ORDER TO PARTICIPATE IN THE PARTIAL REIMBURSEMENT PROGRAM FOR THE FIRST PROGRAM YEAR, TO PROVIDE THE REQUIRED FIRST PROGRAM YEAR CITY MATCH BY INTERGOVERNMENTAL TRANSFER(S) OF FUNDS TO ACHA, AND TO RECEIVE APPROXIMATELY 61.47 PERCENT BACK FROM THE FEDERAL SHARE OF THE PARTIAL REIMBURSEMENT PROGRAM AND 38.53 PERCENT BACK FROM ACHA UNDER THE STATE SHARE OF THE PARTIAL REIMBURSEMENT PROGRAM; AUTHORIZING AND APPROPRIATING FROM ACCOUNT NO. 00001.181000.881000 TO BE TRANSFERRED TO ACHA IN AN AMOUNT NOT TO EXCEED EIGHT HUNDRED NINETY-NINE THOUSAND FOUR HUNDRED SEVEN DOLLARS AND FORTY EIGHT CENTS ($899,407.48) WHICH IS APPROXIMATELY 38.53 PERCENT OF THE FUNDING REQUIRED TO BE PAID AS THE CITY MATCH BY JANUARY 2020, OR SUCH OTHER TIME AS DESIGNATED IN WRITING BY AHCA, IN ORDER FOR THE CITY TO PARTICIPATE IN THE PARTIAL REIMBURSEMENT PROGRAM FOR THE FIRST PROGRAM YEAR AND WILL REQUIRE THAT THE DEPARTMENT'S OPERATING BUDGET BE INCREASED IN THE FISCAL YEAR 2019-20 MID -YEAR BUDGET AMENDMENT; REQUIRING THE CITY MANAGER AND THE DEPARTMENT, BEGINNING OCTOBER 1, 2020, TO PROVIDE TO THE CITY COMMISSION AN ANNUAL REPORT ON THE FIRST PROGRAM YEAR'S PARTICIPATION AND PARTIAL REIMBURSEMENTS TO THE CITY; FURTHER AUTHORIZING THE CITY MANAGER TO NEGOTIATE AND EXECUTE, IN A FORM ACCEPTABLE TO THE CITY ATTORNEY, ALL AMENDMENTS, EXTENSIONS, RENEWALS, AND MODIFICATIONS TO ANY AND ALL FIRST PROGRAM YEAR AGREEMENTS FOR THE PARTIAL REIMBURSEMENT PROGRAM; PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, pursuant to the General Appropriation Act — Laws of the State of Florida 2019-15 and Section 409.908, Florida Statutes, the State of Florida ("State"), through its Agency for Health Care Administration ("ACHA"), has created a new Medicaid Public Emergency Medical Transportation ("PEMT") and Managed Care Emergency Medical System ("EMS") supplement payment program ("Partial Reimbursement Program") to administer Federal funds for reimbursements to local service providers for Medicaid Managed Care patients who ("MMC") are transported to the hospital by PEMT providers and has appropriated $54.787 million for this Partial Reimbursement Program; and WHEREAS, the City of Miami's ("City") Department of Fire -Rescue ("Department") transported 9,330 MMC patients in Fiscal Year 2017-18 and received approximately $1.512 million for this service; and WHEREAS, by participating in the new Partial Reimbursement Program for MMC patients, the City and the Department can substantially increase revenues for MMC patient transports; and WHEREAS, under the new Partial Reimbursement Program, the City and the Department as a provider of MMC patient transports must enter into certain Reimbursement Program Agreement(s) by December 31, 2019 and must send the local matching portion for the state share ("State Share") portion of Partial Reimbursement Program by January 2020, or such other time as designated in writing by AHCA, for the first program year ("First Program Year") ending June 30, 2020 by means of an intergovernmental transfer to AHCA in order to allow the State to certify the public expenditure incurred by the Department and to become eligible to receive the Federal share ("Federal Share") for partial reimbursement to the City and the Department; NOW, THEREFORE, BE IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI, FLORIDA: Section 1. The recitals and findings contained in the Preamble to this Resolution are adopted by reference and incorporated as if fully set forth in this Section. Section 2. The City is authorized' to participate in and to receive reimbursements under the Partial Reimbursement Program for MMC patients transported by the Department with administration of Federal funds by the State through ACHA for the First Program Year ending June 30, 2020. Section 3. The City Manager is hereby authorized' to negotiate and execute any and all necessary agreements, all in a form acceptable to the City Attorney, in order to participate in the Partial Reimbursement Program for the First Program Year, to provide the required First Program Year City match by intergovernmental transfer(s) of funds to ACHA, and to receive approximately 61.47 percent back from the Federal Share of the Partial Reimbursement Program and 38.53 percent back from the State Share of the Partial Reimbursement Program. Section 4. An amount not to exceed eight hundred ninety-nine thousand four hundred seven dollars and forty eight cents ($899,407.48) is authorized' and appropriated from Account No. 00001.181000.891000 to be transferred to ACHA which is approximately 38.53 percent of the funding required to be paid as the City match by January 2020, or such other time as designated in writing by AHCA, in order for the City to participate in the Partial Reimbursement Program for the First Program Year. Section 5. The City Manager and the Department, beginning October 1, 2020, are required to provide to the City Commission an annual report on the First Program Year's participation and partial reimbursements to the City. Section 6. The City Manager is further authorized' to negotiate and execute, in a form acceptable to the City Attorney, all amendments, extensions, renewals, and modifications to any and all First Program Year Agreements for the Partial Reimbursement Program. Section 7. This Resolution shall become effective immediately upon its adoption and signature of the Mayor.2 APPROVED AS TO FORM AND CORRECTNESS: ndez, ity ttor ey 12/2/2019 1 The herein authorization is further subject to compliance with all requirements that may be imposed by the City Attorney including but not limited to those prescribed by applicable City Charter and City Code provisions. 2 If the Mayor does not sign this Resolution, it shall become effective at the end of ten (10) calendar days from the date it was passed and adopted. If the Mayor vetoes this Resolution, it shall become effective immediately upon override of the veto by the City Commission.