Resoltuion 2023-32796RESOLUTION NO. 2023-32796
A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF
MIAMI BEACH, FLORIDA, AUTHORIZING THE CITY'S FIRE DEPARTMENT
TO PARTICIPATE IN INTERGOVERNMENTAL TRANSFERS ("IGT") WITH
THE STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION
("AHCA") AND THE SUPPLEMENTAL PAYMENT PROGRAM FOR
MEDICAID MANAGED CARE PATIENTS ("PROGRAM"), DURING THE
STATE BUDGET PERIOD FROM JULY 1, 2023 THROUGH JUNE 30, 2024
FOR THE FIFTH PROGRAM YEAR; AND FURTHER AUTHORIZING THE
CITY MANAGER TO EXECUTE ANY REQUIRED AGREEMENTS OR
DOCUMENTS RELATING TO THE CITY'S PARTICIPATION IN THE
PROGRAM, SUBJECT TO REVIEW AND APPROVAL BY THE CITY
ATTORNEY.
WHEREAS, the State of Florida has created a supplemental payment program for Medicaid
managed care patients who are transported to the hospital by public emergency medical
transportation providers and has appropriated an additional $94.1 million for this program; and
WHEREAS, the City of Miami Beach Fire Department ("MBFD") transports approximately
400 Medicaid managed care patients annually to hospitals and only receives approximately $115
per patient for this service; and
WHEREAS, by participating in the supplemental payment program for Medicaid managed
care patients (the "Program"), the MBFD can substantially increase its Medicaid managed care
patient transport revenue and provide better services to the community; and
WHEREAS, the proposed operating budget for the MBFD includes an appropriation of-
$133,129.24 for intergovernmental transfers ("IGT") to support the supplemental payment program
for Medicaid managed care patients, and a corresponding $316,672.79 for Medicaid managed care
transport revenue; and
WHEREAS, each year, based upon statistics from the prior year, the State of Florida
Agency for Health Care Administration ("AHCA") calculates how many patients, who are covered by
a Medicaid Health Maintenance Organization insurance plan ("Medicaid Managed Care Patients"),
are transported to hospitals by counties and municipalities ("Governmental Entities"); and
ti
WHEREAS, AHCA determines the total projected, uncovered costs associated with these
transportation services ("Medicaid Managed Care Shortfall"), and assigns each Governmental Entity
its proportionate share of the transport services provided; and
WHEREAS, on September 14, 2022, the Mayor and City Commission adopted Resolution
No. 2022-32275, approving the "Fourth Program year", funded by the State of Florida's budget for
the period from July 1, 2022 through June 30, 2023; and
WHEREAS, AHCA will pay the Medicaid HMO insurance companies, who are the insurers
for the Medicaid Managed Care Patients, their proportionate share of up to 58% of the approved
federal funds; and
WHEREAS, each Governmental Entity is expected to front 42% of its proportionate share of
the Medicaid Managed Care Shortfall, which will be refunded by AHCA, and each eligible
Government Entity will be paid, by the Medicaid HMO insurers, an amount of up to 58% of the
estimated Medicaid Managed Care Shortfall; and
WHEREAS, the City's total allocation of Medicaid Managed Care Shortfall funds is
$316,672.79; and
WHEREAS, the City will have to remit $133,129.24 to AHCA, representing the City's 42%
share of the Medicaid Managed Care Shortfall ("City's Portion") for the Fifth Program Year;
however, under the Program, the City will receive a refund from AHCA for the City's Portion; and
WHEREAS, the City will also receive the supplemental funds, in an amount up to 58% of -the
projected Medicaid Managed Care Shortfall from the Medicaid HMO insurers of the Medicaid
Managed Care Patients who received transportation services during the operative year, in the total
sum of up to $183,543.55; and
WHEREAS, unlike the Certified Public Expenditure ("CPE") program, which required no
appropriation for the State share, these revenue and expense estimates are forward -looking to
allow participation by the MBFD; and
WHEREAS, the Administration recommends authorizing the City Manager to execute all
required agreements or documents relating to the City's participation in the Program for the fifth
program year.
NOW, THEREFORE BE IT DULY RESOLVED BY THE MAYORAND CITY COMMISSION
OF THE CITY OF MIAMI BEACH FLORIDA, that the Mayor and City Commission hereby authorize
the City's Fire Department ("MBFD") to participate in intergovernmental transfers ("IGT") with the
State of Florida Agency for Health Care Administration ("AHCA") and the supplemental payment
program for Medicaid managed care patients ("Program"), during the State budget period from July
1, 2023 through June 30, 2024 for the fifth program year; and further authorize the City Manager to
execute any required agreements or documents relating to the City's participation in the Program,
subject to review and approval by the City Attorney.
PASSED and ADOPTED this /f day of Od(4er , 2023.
ATTEST:, OCT 2.0 2023
Rafael E. Granado, City, Clerk
Dan Gelber, Mayor
APPROVED AS TO
FORM & LANGUAGE
& FOR EXECUTION
I u --6- 23
City Attorney Date
Resolutions - C7 C
MIAMI BEACH
COMMISSION MEMORANDUM
TO: Honorable Mayor and Members of the City Commission
FROM: Alina T. Hudak, City Manager
DATE: October 18, 2023
SUBJECT: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY
OF MIAMI BEACH, FLORIDA, AUTHORIZING THE CITY'S FIRE
DEPARTMENT TO PARTICIPATE IN INTERGOVERNMENTAL TRANSFERS
("IGT") WITH THE STATE OF FLORIDA AGENCY FOR HEALTH CARE
ADMINISTRATION ("AHCA") AND THE SUPPLEMENTAL PAYMENT
PROGRAM FOR MEDICAID MANAGED CARE PATIENTS ("PROGRAM"),
DURING THE STATE BUDGET PERIOD FROM JULY 1, 2023 THROUGH
JUNE 30, 2024 FOR THE FIFTH PROGRAM YEAR; AND FURTHER
AUTHORIZING THE CITY MANAGER TO EXECUTE ANY REQUIRED
AGREEMENTS OR DOCUMENTS RELATING TO THE CITY'S
PARTICIPATION IN THE PROGRAM, SUBJECT TO REVIEW AND
APPROVAL BY THE CITYATTORNEY.
RECOMMENDATION
It is recommended that the Mayor and City Commission of the City of Miami Beach approve the
attached resolution authorizing an I ntergovemmental Transfer (I GT) program between the City
of Miami Beach and the State of Florida (State) to provide a supplemental payment program for
Medicaid Managed Care patients. The resolution also authorizes the City Manager to execute all
required documents, including provider contracts and agreements with the Agency for Health
Care Administration (AHCA), subject to ratification, to implement the supplemental payment
program.
BACKGROUND/HISTORY
In 2018, the State of Florida authorized creation of a Certified Public Expenditure (CPE)
program to provide supplemental payments to publicly owned and operated emergency medical
transportation providers for Medicaid fee service patients transported to local hospitals. These
funds are appropriated from the Medical Care Trust Fund for the Certified Public Expenditures
Program for Emergency Transportation Services and supplement the managed Medicaid
shortfall. The program helps providers recover their share of federal Medicaid reimbursement
by allowing the State to certify the public expenditures incurred yearly by MBFD as the State
share.
ANALYSIS
Miami Beach Fire Department transports approximately 7,000 patients annually to local hospital
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emergency rooms, generating approximately $2 million per year from Medicare, Medicaid,
private commercial insurance companies and individual payers. A small percentage of the
patients transported to the hospital each year are covered by Medicaid. The average
reimbursement for the services per Medicaid patient is on average $115. This amount is
significantly lower when compared to reimbursements of $275 and $501 from Medicare and
patients with private health insurance, respectively. The State (CPE) program helps cover the
gap between Medicaid payments and the shortfall.
SUPPORTING SURVEY DATA
N/A
Authorizing CMBFD to make an IGT payment to the state, in the amount not to
exceed $133,129.24 representing 42% (Citys portion) of the projected City's uncovered costs
to transport patients (who are insured by a Medicaid managed care insurance plan) to the
hospital (Medicaid managed care shortfall); and authorizing the city to accept the reimbursement
of the city's portion from the state, plus payments from the participating Medicaid managed care
insurance companies, in the collective amount of $316,672.79 (total net supplemental
payments), representing 58% of the Medicaid managed care shortfall.
Amount(s)/Account(s):
Account(s) 011-1220-Amount(s) $133,129.24, 000312-19-401-505-00-00-00-Professional Services
CONCLUSION.
The Mayor and City Commission hereby recommend the approval of this resolution.
Applicable Area
Not Applicable
Is this a "Residents Right
to Know" item. pursuant to
City Code Section 2-14?
No
Legislative Tracking
Fire
ATTACHMENTS:
Description
o RESO Form Approved
Does this item utilize G.O.
Bond Funds?
No
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