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Home My WebLink About23567AGREEMENT INFORMATION AGREEMENT NUMBER 23567 NAME/TYPE OF AGREEMENT SUNSHINE STATE HEALTH PLAN, INC. DESCRIPTION LETTER OF AGREEMENT/MEDICAID SUPPLEMENTAL PAYMENTS FOR EMERGENCY TRANSPORTATION SERVICES/FILE ID: 6444/R-19-0512/MATTER ID: 20-1836 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 a3 50 ORIGINATING DEPARTMENT: Fire -Rescue DEPT. CONTACT PERSON: Maria T. Martinez NAME OF OTHER CONTRACTUAL PARTY/ENTITY: "Sunshine State Health Plan, Inc." IS THIS AGREEMENT A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? ❑ YES X NO TOTAL CONTRACT AMOUNT: $ FUNDING INVOLVED? ❑ YES X NO Shine TYPE OF AGREEMENT: ❑ MANAGEMENT AGREEMENT ❑ PUBLIC WORKS AGREEMENT PROFESSIONAL SERVICES AGREEMENT ❑ MAINTENANCE AGREEMENT GRANT AGREEMENT ❑ INTER -LOCAL AGREEMENT ❑ EXPERT CONSULTANT AGREEMENT ❑ LEASE AGREEMENT ❑ LICENSE AGREEMENT El PURCHASE OR SALE AGREEMENT EXT. 1672 OTHER: (PLEASE SPECIFY) Letter of Agreement between the City of Miami Department of Fire - Rescue and Sunshine State Health 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 ti Date PLEASE PRINT AND SIGN APPROVAL BY DEPARTMENTAL DIRECTOR 8/28/2020 PRINT: Ty McGann, AFC --07137.___ SIGNATURE: SUBMITTED TO RISK MANAGEMENT 8/31 /20 PRINT: ANN — MARIE, SHARPE ' SIGNATURE: ;f�/ SUBMITTED TO CITY ATTORNEY (20-1836 - GKW) 9/10/20 PRINT: VICTORI4 MENDEZ SIGNATURE:/s George K. Wysong, III APPROVAL BY ASSISTANT CITY MANAGER PRINT: SIGNATURE: RECEIVED BY CITY MANAGER PRINT: ART NORIEGA (ei( SIGNATURE: kk 1) ONE ORIGINAL TO CITY CLERK; PRINT: SIGNATURE: PIGNATURE: PRINT: SIGNATURE: 2) ONE COPY TO CITY ATTORNEY'S OFFICE; 3) REMAINING ORIGINAL(S)TO ORIGINATING DEPARTMENT"- PLEASE ATTACH THIS ROUTING FORM TO ALL DOCUMENTS THAT REQUIRE EXECUTION BY THE CITY MANAGER 47" LETTER OF AGREEMENT This Letter of Agreement ("LOA") is: made and entered into on :the day of August , 2020 by and between the City of Miami, a municipal corporation of the State of 'Florida ("City"), whose principal address is 350,0 Pan Ameridati Drive, Miami, Florida:33133, on behalf of its Departmentof Fire -Rescue ("Departmenr and "government Owned Emergency Medical Service (EMS) :Provider') and Sunshine State Health Plan, Inc., a inanaged care organization operating the Statewide Medicaid Managed Care plan and if applicable, the Children's Medical Services plan ("Medicaid Managed Care Organization" and eMedicaid 'MCOD), operating under the Jaws of the State of Florida; whose principal address is 1301 International Parkway, 4th Floor, Sunrise, FL 33323, (herein referred to individually as "Party" and collectivelyas "Parties"). WHEREAS, the Medicaid MCO has been awarded a contract ("AHCA COntrace)by the Agency foil-101th. Care AdMinistration: ("ARCA") to dellyer. managed care Service.Slo Medicaid enrollees under an 1115 Managed Medicai Assistance Waiver (the "Waiver") in Region fl, Midi includes Miami -Dade and Monroe,- Counties where Government Owned EMS Provider -is located and/or operates; and. WHEREAS, pursuant tO city COMMission Resolution 19:0512, adopted Depernber 12; 2019 ("Authorizing Resolution"), the City on behalf ofthe 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 rOfernergency transportation services ta Medicaid beneficiaries. within the Government Owned EMS Provider's areas of operation'ovhich 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 fl on an as needed basis, when the transport and treatment -are appropriate; and Pagel c;r4 WHEREAS, the Centers for Medicare and Medicaid Services ("CMS") approved Title 42 Code of Federal Regulations Section 438.6 rSection 438.6") directed payments based on the establishment of a uniform increase to be paid to qualifying Government Owned EMS Providers forthe provision Of emergency medical services to Medicaid eligible persons enrolled in managed care organizations pursuant to the Waiver, which incliidea- the Meditaid-MCO. NOW THEREFORE, Government Owned EMS Provider and the Medicaid MCO do hereby agiteito the following: 1. GovernMent OWried EMS ProVider agrees to Make emergency medical services available to MCO's Medicaid enrollees on an as needed basis, whenthe transport and treatment are appropriate. 2. Medicaid MCO shall receive per member per month Section 438.6 direpted it?'ayindnts for care and treatment provided by the Government Owned EMS Provider, which the Medicaid MCQ shall. timely -remit to the:Government Owned EMS Provider in accordance with A.HCA's contractual requirement, includingpublic records .compliance, record, keeping, reporting,. auditing, payment monitoring requireMents, nOtiees,, arid limitations on assignments, tO suboontraet6rS iinder.the AHCA Contract and the City LOA. 3. Contact, informatiOn for the Partjei aa folloWs: Government Owned EMS Provider:. Robert M. Jorge MPA Assistant Fire Chief Health ;?,L 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) 3,05-416-5444 (Fax) Email: riorgeetniamigov.com Page2 of 4 Medicaid MCO: Attn: President/CEO Sunshine State Health Plan, Inc. 1301 International Parkway, 4t.h Floor Sunrise, FL 33323 4. The Parties agree any Modificaticiar to this LOA .Shall be in the same 'form, nainely the exchange Of signed copies ofa revised LOA. -5. This LOAcovers the pericki of Oetoberl.; 2019,llirotigh June 30, 2024, unless terminated sooner by the termination Pf Seetion 438.6 directed payments. 6. This,LOA;rnay beexecnted:in several counterparts,, all or any:of whichshall be regarded for all purposes as one Original and shall constitute and be but one andthe same ifistruMent, An 4ectited faeSiniile or eleetroitie 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 transmisaion), 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 signedLpA 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: Sunshine State Health Plan, Inc. By: William M. K..ruegel, Chief Operating Officer Name & Title of Authorized Individual' Signs r fAuthort d Individual Date; 08/28/2020 Page 3 of 4 A )ll. Name: AliqA) \601\fi Date: GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER: CITY OF MIAMI, a municipal corporation of the State of Florida By: ur N iega V, City Manager Date: ti0W Attest: Todd B. Han • t Clerk Date: C\ 111 Approved as to Insurance Requirements: Approved as to Legal Form and Correctness: // By: Ann -Marie Sharpe. Director Department of Risk Management By: 3a-t a _ . _. 7 a/t1/4 Victoriaendez, City Attorney Page 4 of 4 (20-1836 - GKW)