TO: Mayor and Commissioners
FROM: L. Keith Tomey III, Fire Chief
THROUGH: Terrence R. Moore, ICMA-CM
DATE: September 19, 2022
Title
APPROVAL OF A LETTER OF AGREEMENT (LOA) WITH THE FLORIDA AGENCY FOR HEALTHCARE ADMINISTRATION (AHCA) FOR PARTICIPATION IN THE MANAGED CARE ORGANIZATION (MCO) PORTION OF THE PUBLIC EMERGENCY MEDICAL TRANSPORTATION (PEMT) PROGRAM.
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Recommended Action:
Recommendation
Staff recommends approval of the Letter of Agreement (LOA) with AHCA to facilitate additional reimbursement of Medicaid dollars for providing emergency medical transportation to individuals covered by one of Medicaid’s Managed Care Organizations.
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Background:
AHCA is the agency responsible for administering Medicaid in the State of Florida. Participation in the MCO - PEMT program is expected to generate an estimated $441,126.27 of additional revenue for providing these services. The City of Delray Beach has participated in FL PEMT MCO program since Year 2. The LOA for this meeting is for Year 4 of the MCO program.
To accept these funds the program requires Inter- Governmental Transfers (IGT), or a payment by the City to AHCA at an estimated total of $176,229.95. This would mean approximately $264,896.32 of new net revenue to the City.
The City currently participates in the Fee For service (FFS) portion of the PEMT program, which generated nearly $828,000 in fiscal year 2019-20. The MCO portion of the PEMT program is not available until year two of participation. As such, the execution of this LOA by October 1, 2022 is a requirement for participation. Additional reimbursement dollars will be paid directly to the City’s Medicaid collection account by the MCO’s as those funds are distributed to them by AHCA.
City Attorney Review:
Approved as to form and legal sufficiency.
Funding Source/Financial Impact:
Funding is available from the Fire Administration budget account number 001-22-000-522.31-90.
The IGT amount was included in the budget proposal for FY 22-23. If approved, the IGT payments would be made to AHCA, allowing AHCA to draw down additional federal funds for this program. AHCA in turn, provides additional funding to the MCO’s and each of the MCO’s would remit the additional Medicaid transport dollars directly to the City totaling an estimated $55,649.62.
Timing of Request:
This agreement must be fully executed and returned to AHCA prior to October 1, 2022.