Resolution 2024-33309 RESOLUTION NO. 2024-33309
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, 2024 THROUGH JUNE 30, 2025;
"SIXTH 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
$209,094.05;for intergovernmental transfers("IGT")to support the supplemental payment program
for Medicaid managed care patients and a corresponding$488,195.31 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,on October 18,2023,the Mayor and City Commission adopted Resolution No.
2023-32796, approving the "Fifth Program year", funded by the State of Florida's budget for the
period from July 1, 2023 through June 30, 2024; 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 57% of the approved
federal funds; and
WHEREAS, each Governmental Entity is expected to front 43%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 57% of the
estimated Medicaid Managed Care Shortfall; and
WHEREAS, the City's total allocation of Medicaid Managed Care Shortfall funds is
$488,195.31; and
WHEREAS, the City will have to remit$209,094.05 to AHCA, representing the City's 43%
share of the Medicaid Managed Care Shortfall ("City's Portion") for the Sixth 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 57%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 $279,101.26; 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 fourth
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, 2024 through June 30, 2025; 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 .Jo day of 66 ✓ , 2024.
ATTEST:
72s4 Steven Meiner, Mayor
NOV 0 5 2024
APPROVED AS TO
Rafael E. Granado, City Clerk FORM & LANGUAGE
& Fk' ELUTION
.I� /olzv)zoz!-
ii:CORPORATE%,RPORATE%,= Ci7''ttomey r Date
Resolutions - C7 F
MIAMI BEACH
COMMISSION MEMORANDUM
TO: Honorable Mayor and Members of the City Commission
FROM: Eric Carpenter, City Manager
DATE: October 30, 2024
TITLE: 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, 2024 THROUGH JUNE 30, 2025; "SIXTH 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 (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
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
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
Page 488 of 2497
payments and the shortfall.
FISCAL IMPACT STATEMENT
Authorizing CMBFD to make an IGT payment to the state, in the amount not to exceed
$209,094.05 representing 43% (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 $488,195.31 (total net supplemental payments),
representing 57% of the Medicaid managed care shortfall.
Does this Ordinance require a Business Impact Estimate?
(FOR ORDINANCES ONLY)
If applicable, the Business Impact Estimate (BIE) was published on:
See BIE at: https://www.miamibeachfl.gov/city-hall/city-clerk/meeting-notices/
FINANCIAL INFORMATION
CONCLUSION
The Administration recommends that the Mayor and City Commission approve this resolution.
Applicable Area
Citywide
Is this a "Residents Right to Know" item, Is this item related to a G.O. Bond
pursuant to City Code Section 2-17? Project?
No No
Was this Agenda Item initially requested by a lobbyist which, as defined in Code Sec. 2-481,
includes a principal engaged in lobbying? No
If so, specify the name of lobbyist(s) and principal(s):
Department
Fire
Sponsor(s)
Co-sponsor(s)
Page 489 of 2497
Condensed Title
Authorize Fire Dept to Participate in IGT with AHCA. FD
Page 490 of 2497
RESOLUTION NO. 2024-00000
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,
2024 THROUGH JUNE 30, 2025; "SIXTH 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
$209,094.05; for intergovernmental transfers ("IGT") to support the supplemental payment
program for Medicaid managed care patients and a corresponding $488,195.31 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, on October 18, 2023, the Mayor and City Commission adopted Resolution
No. 2023-32796, approving the "Fifth Program year", funded by the State of Florida's budget for
the period from July 1, 2023 through June 30, 2024; 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 57% of the
approved federal funds; and
Page 491 of 2497
WHEREAS, each Governmental Entity is expected to front 43% 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 57%
of the estimated Medicaid Managed Care Shortfall; and
WHEREAS, the City's total allocation of Medicaid Managed Care Shortfall funds is
$488,195.31; and
WHEREAS, the City will have to remit $209,094.05 to AHCA, representing the City's
43% share of the Medicaid Managed Care Shortfall ("City's Portion") for the Sixth 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 57% 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 $279,101.26; 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
fourth 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, 2024 through June 30, 2025;
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 , 2024.
ATTEST:
Steven Meiner, Mayor
Rafael E. Granado, City Clerk
Page 492 of 2497