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Home My WebLink About23561AGREEMENT INFORMATION AGREEMENT NUMBER 23561 NAME/TYPE OF AGREEMENT CHILDREN'S MEDICAL SERVICES PLAN/WELLCARE OF FLORIDA D/B/A STAYWELL DESCRIPTION LETTER OF AGREEMENT/MEDICAID SUPPLEMENTAL PAYMENT FOR EMERGENCY TRANSPORTATION SERVICES/FILE ID: 6444/R-19-0512/MATTER ID:20-1824 EFFECTIVE DATE August 17, 2020 ATTESTED BY TODD B. HANNON ATTESTED DATE 9/11/2020 DATE RECEIVED FROM ISSUING DEPT. 8/20/2021 NOTE CITY OF MIAMI DOCUMENT ROUTING FORM ab5Le6 ORIGINATING DEPARTMENT: Fire -Rescue DEPT. CONTACT PERSON: Maria T. Martinez EXT. 1672 NAME OF OTHER CONTRACTUAL PARTY/ENTITY: "Children's Medical Services Plan/WellCare of Florida d/b/a Staywell" IS THIS AGREEMENT A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? El YES X NO TOTAL CONTRACT AMOUNT: $ , FUNDING INVOLVED? ❑ YES X NO TYPE OF AGREEMENT: ❑ MANAGEMENT AGREEMENT PROFESSIONAL SERVICES AGREEMENT GRANT AGREEMENT El EXPERT CONSULTANT AGREEMENT El LICENSE AGREEMENT ❑ PUBLIC WORKS AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ INTER -LOCAL AGREEMENT ❑ LEASE AGREEMENT ❑ PURCHASE OR SALE AGREEMENT OTHER: (PLEASE SPECIFY) Letter of Agreement between the City of Miami Department of Fire - Rescue and Children's Medical Services Plan/WellCare of Florida d/b/a Staywell. PURPOSE OF ITEM (BRIEF SUMMARY): The City on behalf of the Dept. as a Government Owned Emergency Medical Services ("EMS") Provider has entered into LOA regarding Medicaid supplemental payments for emergency transportation services. COMMISSION APPROVAL DATE: 12/12/19 FILE ID: 7734 ENACTMENT NO.: R-19-0512 IF THIS DOES NOT REQUIRE COMMISSION APPROVAL, PLEASE EXPLAIN: ROUTING INFORMATION, . b . Date PLEASE PRINT AND SIGN APPROVAL BY DEPARTMENTAL DIRECTOR 8/27/2020 PST: Ty McGann, SIGNATURE: AFC A/f�j _/7 (A- SUBMITTED TO RISK MANAGEMENT 8/28/20 PRINT: ANN — MADE HARPE SIGNATURE: , f ;` r` SUBMITTED TO CITY ATTORNEY (20-1824 - GKW) 9/10/20 PRINT: VICTORIA MENDEZ SIGNATURE•/s George K. Wysong, 111 APPROVAL BY ASSISTANT CITY MANAGER PRINT: SIGNATURE: RECEIVED BY CITY MANAGER PRINT: ART :�1 SIGNAT 11'. : Al RIEGA ( . 1) QNEORLGINA(TO.CITYCLERK PRINT: SIGNATURE: PST: SIGNATURE: PRINT: SIGNATURE: 2) ON ECOPY ?b.-WY ATTORNEY'S OFFI"`"CE, 3) REMAININGORIGINAL(S_) TOORIGINATING DEPARTMENT PLEASE ATTACH THIS ROUTING FORM TO ALL DOCUMENTS THAT REQUIRE EXECUTION BY THE CITY MANAGER LETTER OF AGREEMENT This Letter of Agreement ("LOA") is made and entered into on the 17th day of August , 2020 by and between the City of Miami, a municipal corporation of the State of Florida ("City"), whose principal address is 3500 Pan American Drive, Miami, Florida 33133, on behalf of its Department of Fire -Rescue ("Department" and "Government Owned Emergency Medical Service (EMS) Provider") and Children's Medical Services Plan/WellCare of Florida d/b/a Stavwell, a managed care organization duly organized under the laws of the State of Florida, whose principal address is 8725 Henderson Road Tampa, Florida 33634 as a Medicaid Managed Care Organization ("Medicaid MCO") (herein referred to individually as "Party" and collectively as "Parties"). WHEREAS, the Medicaid MCO has been awarded a contract ("AHCA Contract") by the Agency for Health Care Administration ("AHCA") to deliver managed care services to Medicaid enrollees under an 1115 Managed Medical Assistance Waiver (the "Waiver") in Region 11, which includes Miami -Dade and Monroe Counties where Government Owned EMS Provider is located and/or operates; and ! WHEREAS, pursuant to City Commission Resolution No. 19-0512, adopted December 12, 2019 ("Authorizing Resolution"), the City on behalf of the Department as a Government Owned Emergency Medical (EMS) Provider has entered into a Letter of Agreement, dated December 31, 2019, including all extensions and renewals thereof, with ACHA ("City LOA"), regarding Medicaid supplemental payments for emergency transportation services to Medicaid beneficiaries within the Government Owned EMS Provider's areas of operation, which Authorizing Resolution authorizes the City Manager to negotiate and execute this related LOA, in a form acceptable to the City Attorney; and WHEREAS, AHCA has approved the Government Owned EMS Provider as a qualifying entity and provides out of network emergency medical services to Medicaid MCO enrollees in Region 11 on an as needed basis, when the transport and treatment are appropriate; and Page 1 of 4 WHEREAS, the Centers for Medicare and Medicaid Services ("CMS") approved Title 42 Code of Federal Regulations Section 438.6 ("Section 438.6") directed payments based on the establishment of a uniform increase to be paid to qualifying Government Owned EMS Providers for the provision of emergency medical services to Medicaid eligible persons enrolled in managed care organizations pursuant to the Waiver, which includes the Medicaid MCO. NOW THEREFORE, Government Owned EMS Provider and the Medicaid MCO do hereby agree to the following: 1. Government Owned EMS Provider agrees to make emergency medical services available to MCO's Medicaid enrollees on an as needed basis, when the transport and treatment are appropriate. 2. Medicaid MCO shall receive per member per month Section 438.6 directed payments for care and treatment provided by the Government Owned EMS Provider, which the Medicaid MCO shall timely remit to the Government Owned EMS Provider in accordance with AHCA's contractual requirements, including public records compliance, record keeping, reporting, auditing, payment monitoring requirements, notices, and limitations on assignments to subcontractors under the AHCA Contract and the City LOA. 3. Contact information for the Parties is as follows: Government Owned EMS Provider: Robert M. Jorge MPA Assistant Fire Chief Health & Emergency Medical Services Division City of Miami Dept. of Fire -Rescue 1151 NW 7 Street, Miami, FL 33136 305-416-5404 (Ph.) 786-351-3591 (Cell) 305-416-5444 (Fax) Email: rjorge(a�miamigov.com Medicaid MCO: Page 2 of 4 Janette Redkey White Sr. Manager, Network Management — West/South Florida WellCare Health Plans, Inc. 200 West Waters Avenue Tampa, FL 33604 813-206-3656 (Ph.) 813-675-2652 (Fax) Janette. white(&, wellcare. com 4. The Parties agree any modification to this LOA shall be in the same form, namely the exchange of signed copies of a revised LOA. 5. This LOA covers the period of October 1, 2019, through June 30, 2024, unless terminated sooner by the termination of Section 438.6 directed payments. 6. This LOA may be executed in several counterparts, all or any of which shall be regarded for all purposes as one original and,shall constitute and be but one and the same instrument. An executed facsimile or electronic scanned copy of this LOA shall have the same force and effect as an original. The Parties shall be entitled to sign and transmit an electronic signature on this LOA (whether by facsimile, PDF, or other email transmission), which signature shall be binding on the party whose name is contained therein. Any party providing an electronic signature agrees to promptly execute and deliver to the other party an original signed LOA upon written request. IN WITNESS WHEREOF, the Parties have duly executed this LOA on the day and year above first written. Each party represents that: (i) it has the authority to enter into this Agreement; and (ii) that the individual(s) signing this Agreement on its behalf is/are authorized to do so. MEDICAID MANAGED CARE ORGANIZATION: Children's Medical Services Plan/WellCare of Florida By: Mark J. Fehring, VP Network Mangement Name & Title of Authorized Individual Page 3 of 4 Signature of uthorized In Date: 8-27-2020 Attest: Name: Date: e vidual Title GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER: CITY OF MIAMI, a municipal corporation of the State of Florida By: Arthur Nbtiega V, City Manager Date: "I 10 i o G Attest: Date: Todd B. Hannon, -' Clerk critilapa.0 Approved as to Insurance Requirements: Approved as to Legal Form and Correctness: By: ! By: 9a44 lr , L. %lei. e/6/e Ann -Marie Sharpe, Director Victoriendez, City Attorney Department of Risk Management Page 4 of 4 (20-1824 - GKW)