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The Indian River County Emergency Services District and the Agency agree that any modifications to this LOA shall be in the same form, namely the exchange of signed copies of a revised LOA. 6. Indian River County Emergency Services District confirms that there are no pre -arranged agreements (contractual or otherwise) between the respective counties, taxing districts, and/or the providers to re -direct any portion of these aforementioned supplemental payments in order to satisfy non -Medicaid, non -uninsured, and non -underinsured activities. 7. Indian River County Emergency Services District agrees the following provision shall be included in any agreements between Indian River County Emergency Services District and local providers where IGT funding is provided pursuant to this LOA. Funding provided in this agreement shall be prioritized so that designated IGT funding shall first be used to fund the Medicaid program and used secondarily for other purposes. 8. This LOA covers the period of July 1, 2019 through June 30, 2020 and shall be terminated June 30, 2020. 9. This LOA may be executed in multiple counterparts, each of which shall constitute an original, and each of which shall be fully binding on any party signing at least one counterpart. PEMT Local Intergovernmental Transfers Program / Amount State Fiscal Year 2019-2020 Minimum Fee Schedule/MCO IGTs $146,342.14 Total Funding $146,342.14 IN WITNESS WHEREOF, the parties have caused this page Letter of Agreement to be executed by their undersigned officials as duly authorized. Indian River County Emergency Services District SIGNED BY: NAME: TITLE: DATE: STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION SIGNED BY: NAME: TITLE: DATE: Indian River County Emergency Services District_PEMT LOA SFY 2019-20 214