Resolution 2020-31118 RESOLUTION NO. 2020-31118
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, 2019 THROUGH JUNE 30, 2020 ("INITIAL
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 $54.7 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
$53,889.08 for intergovernmental transfers("IGT")to support the supplemental payment program for
Medicaid managed care patients and a corresponding $139,862.65 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
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,the first year of the program(the"Initial Program Year")has been funded by the
State of Florida's budget for the period from July 1, 2019 through June 30, 2020, in the total sum of
$54,786,711.00; 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 61.47%of the approved
federal funds; and
WHEREAS,each Governmental Entity is expected to front 38.53%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, in an amount up to 61.47% of the
estimated Medicaid Managed Care Shortfall; and
WHEREAS, the City's total allocation of Medicaid Managed Care Shortfall funds is
$139,862.65; and
WHEREAS,the City will have to remit$53,889.08 to AHCA, representing the City's 38.53%
share of the Medicaid Managed Care Shortfall ("City's Portion") for the Initial 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 61.47%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 $85,973.57; 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 Initial
Program Year.
NOW,THEREFORE BE IT DULY RESOLVED BY THE MAYOR AND 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, 2019 through June 30, 2020 ("Initial 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 dday of �H llo ry , 2020.
ATTEST:
Dan Gelbe 7ayor
27 2 l
Rafael E. Granado, c ity C erk
vmusvivil
VII ---
. 74,* :�
. .c• Tr S TO
& • 4GUAGE.
r' &FO / ELUTION
.lNooRP r 6
S ORA ED; "i PD�o
♦ '•, Ity AttomeyAie D e
Resolutions-C7 F
MIAMI BEACH
COMMISSION MEMORANDUM
TO: Honorable Mayor and.Members of the City Commission
FROM: Jimmy L. Morales, City Manager
DATE: January 15, 2020
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, 2019 THROUGH
JUNE 30, 2020 ("INITIAL 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.
RECOMMENDATION
It is recommended that the Mayor and City Commission of the City of Miami Beach approve
the attached resolution authorizing an Intergovernmental 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 (ANCA), subject to ratification, to implement the
supplemental payment program.
BACKGROUND/HISTORY
Miami Beach Fire Department transports approximately 7,000 patients annually to local
hospital emergency rooms, generating approximately $2 million per year from Medicare,
Medicaid, private commercial insurance companies and individual payers. The transport
services are billed and collected by a private contractor via R1 (formerly Intermedix) per
Resolution# 2017-002-JC. Of the total patients transported to the hospital each
year, 14% are covered by Medicaid. The average reimbursement for the services per
Medicaid patient is $115. This amount is significantly lower when compared to
reimbursements of $275 and $501 from Medicare and patients with private health insurance,
respectively.
In 2018, the State of Florida authorized creation of a Certified Public Expenditure (CITE)
Page 272 of 1618
program to provide supplemental payments to publicly owned and operated emergency
medical transportation providers for Medicaid fee for service patients transported to local
hospitals. This program leverages the approximately 61.47 percent share of federal Medicaid
reimbursement by allowing the State to certify the public expenditure incurred by CMBFD as
the State share.
ANALYSIS
Miami Beach Fire Department transports approximately 7,000 patients annually to local
hospital emergency rooms, generating approximately $2 million per year from Medicare,
Medicaid, private commercial insurance companies and individual payers. The transport
services are billed and collected by a private contractor via R1 (formerly Intermedix) per
Resolution# 2017-002-JC. Of the total patients transported to the hospital each
year, 14% are covered by Medicaid. The average reimbursement for the services per
Medicaid patient is $115. This amount is significantly lower when compared to
reimbursements of$275 and $501 from Medicare and patients with private health insurance,
respectively.
In 2018, the State of Florida authorized creation of a Certified Public Expenditure (CITE)
program to provide supplemental payments to publicly owned and operated emergency
medical transportation providers for Medicaid fee for service patients transported to local
hospitals. This program leverages the approximately 61.47 percent share of federal Medicaid
reimbursement by allowing the State to certify the public expenditure incurred by CMBFD as
the State share.
FINANCIAL INFORMATION
Authorizing CMBFD to make an IGT payment to the state, in the amount not to exceed
$53,889.08, representing 38.53% (City's 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 $139,862.65 (total net supplemental
payments), representing 61.47% of the Medicaid managed care shortfall.
Account(s) 011-1220- Amount(s) $53,889.08
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 Resident Right to Does this item utilize G.O.
Know item? Bond Funds?
Page 273 of 1618
No No
Legislative Tracking
Fire
ATTACHMENTS:
Description
o Resolution
Page 274 of 1618