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Public Emergency Medical Transportation Letter of Agreement <br />THIS LETTER OF AGREEMENT (LOA) is made and entered into in duplicate on the <br />day of SWC 2020, by and between Indian River County Emergency Services District on <br />behalf of Indian River County ALS, and the State of Florida, Agency for Health Care <br />Administration (the "Agency"), for good and valuable consideration, the receipt and sufficiency <br />of which is acknowledged. <br />DEFINITIONS <br />"Intergovernmental Transfers (IGTs)" means transfers of funds from a non -Medicaid <br />governmental entity (e.g., counties, hospital taxing districts, providers operated by state or local <br />government) to the Medicaid agency. 1GTs must be compliant with 42 CFR Part 433 Subpart B. <br />"Medicaid" means the medical assistance program authorized by Title XIX of the Social Security <br />Act, 42 US.C. §§ 1396 et seq., and regulations thereunder, as administered in Florida by the <br />Agency. <br />"Public Public Emergency Medical Transportation (PEMT)," pursuant to the General Appropriation Act, <br />Laws of Florida 2020-111, is the program that provides supplemental payments for eligible Public <br />Emergency Medical Transportation (PEMT) entities that meet specified requirements and provide <br />emergency medical transportation services to Medicaid beneficiaries. <br />A. GENERAL PROVISIONS <br />Per House Bill 5001, the General Appropriations Act of State Fiscal Year 2020-2021, <br />passed by the 2020 Florida Legislature, Indian River County Emergency Services <br />District and the Agency agree that Indian River County Emergency Services District <br />will remit IGT funds to the Agency in an amount not to exceed the total of $97,570.17. <br />Indian River County Emergency Services District and the Agency have agreed that <br />these IGT funds will only be used for the PEMT program. <br />2. Indian River County Emergency Services District will return the signed LOA to the <br />Agency. <br />3. Indian River County Emergency Services District will pay IGT funds to the Agency in <br />an amount not to exceed the total of $97,570.17. Indian River County Emergency <br />Services District will transfer payments to the Agency in the following manner: <br />a. Per Florida Statute 409.908, annual payments for the months of July 2020 thru <br />June 2021 are due to the Agency no later than October 31, 2020 unless an <br />alternative plan is specifically approved by the agency. <br />b. The Agency will bill Indian River County Emergency Services District when <br />payment is due. <br />4. Indian River County Emergency Services District and the Agency agree that the <br />Agency will maintain necessary records and supporting documentation applicable to <br />Indian River County Emergency Services District Indian River County ALS—PEMT LOA_SFY 2020-21 <br />