Letter of Agreement with Agency for Health Care Administration 2a 12-r2 7 ?,9v
Letter of Agreement
�HIS LETTER OF AGREEMENT made and entered into in duplicate on the ' day of
v� , 2012, by and between City of Miami Beach, Florida (the City) and the State of Florida,
through its Agency for Health Care Administration, (the Agency),
1. Per House Bill 5001, the General Appropriations Act of State Fiscal Year 2012-2013,
passed by the 2012 Florida Legislature, the City and the Agency agree that the City will
remit to the State an amount not to exceed a grand total of$250,000. ,
a. The City and the Agency have agreed that these funds will only be used to
increase the provision of Medicaid funded health services to the people of the
City and the State of Florida at large.
b. The increased provision of Medicaid funded health services will be accomplished
through the buyback of the Medicaid inpatient and outpatient trend adjustments
up to the actual Medicaid inpatient and outpatient cost but not to exceed the
amount specified in the Appropriations Act for public hospitals, including any
leased public hospital found to have sovereign immunity, teaching hospitals as
defined in section 408.07 (45) or 395.805, Florida Statutes, which have seventy
or more full-time equivalent resident physicians, designated trauma hospitals and
hospitals not previously included in the GAA.
2. The City will pay the State an amount not to exceed the grand total amount of$250,000.
The City will transfer payments to the State in the following manner:
a. A lump sum payment of$250,000 will be made by October 30, 2012
3. Timelines: This agreement must be signed and submitted to the Agency no later than
October 1, 2012, to be effective for SFY 2012-2013.
4. The City and the State agree that the State will maintain necessary records and
supporting documentation applicable to Medicaid health services covered by this Letter
of Agreement. Further, the City and State agree that the City shall have access to these
records and the supporting documentation by requesting the same from the State.
5. The City and the State agree that any modifications to this Letter of Agreement shall be
in the same form, namely the exchange of signed copies of a revised Letter of
Agreement.
6. The City confirms that there are no pre-arranged agreements (contractual or otherwise)
between the respective counties, taxing districts, and/or the hospitals to re-direct any
portion of these aforementioned Medicaid supplemental payments in order to satisfy
non-Medicaid activities.
7. This Letter of Agreement is contingent upon the State Medicaid Hospital Reimbursement
Plan reflecting 2012-13 legislative appropriations being approved by the federal Centers
for Medicare and Medicaid Services.
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8. The Agency will reconcile the difference between the amount of the IGTs used by or on
behalf of individual hospitals' buybacks of their Medicaid inpatient and outpatient trend
adjustments or exemptions from reimbursement limitations for SFY 2011-12 and an
estimate of the actual annualized benefit derived based on actual days and units of
service provided. Reconciliation amount may be incorporated into current year (SFY
2012-13) LOAs.
9. This Letter of Agreement covers the period of July 1, 2012 through June 30, 2013 and
shall be terminated June 30, 2013.
SFY 2012-13 Buyback LOA Page 2
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WITNESSETH:
IN WITNESS WHEREOF the parties have duly executed this Letter of Agreement on the day
and year above first written.
City of Miami Beach, Florida State of Florida
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By: By:
Phil E. Williams
Assistant Deputy Secretary for Medicaid
Finance, Agency for Health Care Administration
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Name
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Title
Attest:
I. Gr a'd , t lerk
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APPROVED AS TO
FORM &LANGUAGE
&FOR EXECUTION
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City Attorhb�r` Dat
RECEIVED
SEP 2 7 2012
SFY 2012-13 Buyback LOA Page 3