Resolution 2020-31327 RESOLUTION NO. 2020-31327
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, 2020 THROUGH JUNE 30, 2021; 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 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,which is significantly lower when compared to reimbursements of$275
and $501 from Medicare and patients with private health insurance; and
WHEREAS, in 2018, the State of Florida authorized the 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,that leverages the approximately 61.47%share of federal Medicaid reimbursements,
by allowing the State to certify the public expenditure incurred by counties and municipalities
("Governmental Entities") as the state share; 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 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,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 remit, in advance, an
intergovernmental transfer ("IGT"), in the amount of 38.53% of its proportionate share of the
Medicaid Managed Care Shortfall, which will be refunded by AHCA; and
WHEREAS,additionally, each eligible Govemment Entity will be paid, by the Medicaid HMO
insurers, an amount of up to 61.47% of the estimated Medicaid Managed Care Shortfall; 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, on January 15,2020, the Mayor and City Commission adopted Resolution No.
2020-31118, approving the MBFD's participation in the first year of the Program,which was funded
by the State of Florida's budget for the period from July 1, 2019 through June 30, 2020(the"2019-
2020 State Budget Period"; and
WHEREAS, the City's total allocation of Medicaid Managed Care Shortfall funds for the
2020-2021 State Budget Period has been determined to be $139,862.65; and
WHEREAS, the City will have to remit, in advance, an IGT to AHCA, in the amount of
$53,889.08, representing the City's 38.53%share of the Medicaid Managed Care Shortfall ("City's
Portion")for the 2020-2021 State Budget Period; 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 of 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, the proposed operating budget for the MBFD includes an appropriation of
$53,889.08 for the IGT to support the Program,which will yield to the MBFD a collective amount of
$139,862.65 in Medicaid managed care transport revenue.
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,
2020 through June 30, 2021; 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 _ day of T411/ , 2020.
ATTEST:
Dan Gelber, Mayor
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Rafael E. Granado, City/Clerk
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APPROVED AS TO
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IN(ORP ORATEDi
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City Attorney Date
Resolutions-Cl I
MIAMI BEACH
COMMISSION MEMORANDUM
TO: Honorable Mayor and Members of the City Commission
FROM: Jimmy L. Morales, City Manager
DATE: July 29, 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, 2020 THROUGH
JUNE 30, 2021; 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 (IGT) 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
The Miami Beach Fire Department (MBFD)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
Page 319 of 2461
program leverages the approximately 61.47 percent share of federal Medicaid reimbursement
by allowing the State to certify the public expenditure incurred by MBFD as the State share.
ANALYSIS
The Miami Beach Fire Department (MB FD)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 MBFD as the State share.
FINANCIAL INFORMATION
The City Administration is requesting authorization 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 City to accept the reimbursement
of the City's Portion from the State, plus payments from the participating Medicaid managed
care insurance companies, representing 61.47% of the Medicaid managed care shortfall, for a
total collective amount of$139,862.65 in Medicaid managed care transport revenues.
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.
Is this a"Residents Right Does this item utilize G.O.
to Know" item. pursuant to Bond Funds?
City Code Section 2-14?
No No
Legislative Trackinu
Fire
ATTACHMENTS:
Description
Page 320 of 2461
Q Form approved reso
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