HomeMy WebLinkAbout23564AGREEMENT INFORMATION
AGREEMENT NUMBER
23564
NAME/TYPE OF AGREEMENT
HUMANA MEDICAL PLAN, INC.
DESCRIPTION
LETTER OF AGREEMENT/MEDICAID SUPPLEMENTAL
PAYMENT FOR EMERGENCY TRANSPORTATION
SERVICES/FILE ID: 6444/R-19-0512/MATTER ID: 20-1902
EFFECTIVE DATE
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 b5
ORIGINATING DEPARTMENT: Fire -Rescue
DEPT. CONTACT PERSON: Maria T. Martinez
NAME OF OTHER CONTRACTUAL PARTY/ENTITY: "Humana Medical Plan, Inc."
IS THIS AGREEMENT A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? ❑ YES
TOTAL CONTRACT AMOUNT: $ FUNDING INVOLVED? ❑ YES
1672
TYPE OF AGREEMENT:
❑ MANAGEMENT AGREEMENT
PROFESSIONAL SERVICES AGREEMENT
GRANT AGREEMENT
El EXPERT CONSULTANT AGREEMENT
❑ LICENSE AGREEMENT
EXT.
❑ PUBLIC WORKS AGREEMENT
❑ MAINTENANCE AGREEMENT
❑ INTER -LOCAL AGREEMENT
❑ LEASE AGREEMENT
❑ PURCHASE OR SALE AGREEMENT
X NO
X NO
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OTHER: (PLEASE SPECIFY) Letter of Agreement between the City of Miami Department of Fire -
Rescue and Humana Medical Plan, Inc.
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.
Date
PLEASE PRINT AND SIGN
APPROVAL BY DEPARTMENTAL DIRECTOR
9/9/2020
PRINT: Ty McGann, AFC
yy��
SIGNATURE: —,, `SZ____
SUBMITTED TO RISK MANAGEMENT
9/9/20
PRINT: ANN — MARIE S; " E
SIGNATURE: 1
SUBMITTED TO CITY ATTORNEY
(20-1902 - GKW)
PRINT: VICTORIA MENDEZ
SIGNATURE:/s George K. Wysong, III
APPROVAL BY ASSISTANT CITY MANAGER
PRINT:
SIGNATURE:
RECEIVED BY CITY MANAGER
PRINT: ART NO EGA
f f'
G
SIGNA •
1) ONE ORIGINAL TO CITY CLERK,
PRINT:
SIGNATURE:
PRINT:
SIGNATURE:
PRINT:
SIGNATURE:
2) ONE COPY TO CITY ATTORNEY'S OFFICE;
3) REMAINING ORIGINALS) TO ORIGINATING
DEPARTMENT mm
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 day of
, 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 Humana Medical Plan, Inc., a Florida Profit Corporation,
duly organized under the laws of the State of Florida, whose principal address is 3501 S.W. 160th
Avenue, Miramar, Florida 33027, 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, City represents that 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
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
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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 334136
305-416-5404 (Ph.)
786-351-3591 (Cell)
305-416-5444 (Fax)
Email: rjorge(a�miamigov.com
Medicaid MCO:
Humana Medical Plan, Inc.
Name: Betsy Dennis
Title: Manager, Provider Contracting
Page 2 of 4
Phone: 727 453 8131
Email: EDennis6@humana.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 counterpart signature pages, 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:
HUMANA MEDICAL PLAN, INC., a Florida Profit Corporation
By: Lori Dunne, Regional VP Operations
Name & Title of Authorized Individual
Ignature thorized Individual
Date: 9/8/2020
Page 3 of 4
Attest:
Name:
Date:
Title
GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER:
CITY OF MIAMI, a municipal corporation of the State of Florida
By: Ce(c)
A hur No eg V, rty Manager
Date: G 101 tt11,0
Attest:
Date:
Todd B. Hann. - . _ . Clerk
`D' (" (ao
Approved as to Insurance Requirements: Approved as to Legal Form and Correctness:
By:
Ann -Marie Sharpe, Director
Department of Risk Management
By: ga,,ta.6y_ ,L. +v ,veAk
VictoriMendez, City Attorney
(20-1902 - GKW)
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