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.

It is recommended that the Mayor and City Commission of the City of Miami Beach approve the attached resolution authorizing an Intergovemmental 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.

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.

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 payments and the shortfall.

Authorizing CMBFD to make an IGT payment to the state, in the amount not to exceed $133,129.24 representing 42% (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 $316,672.79 (total net supplemental payments), representing 58% of the Medicaid managed care shortfall.

The Mayor and City Commission hereby recommend the approval of this resolution.