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Directed Payment Program Letter of Agreement THIS L TT R OF AGREEMENT (LOA) is made and entered into in duplicate on the day of 2021, by and between Indian River County LPPF on behalf of Region 9, and the State of lorida, Agency for Health Care Administration (the "Agency"), for good and valuable consideration, the receipt and sufficiency of which is acknowledged. DEFINITIONS "Intergovernmental Transfers (IGTs)" means transfers of funds from a non -Medicaid governmental entity (e.g., counties, hospital taxing districts, providers operated by state or local government) to the Medicaid agency. IGTs must be compliant with 42 CFR Part 433 Subpart B. "Medicaid" means the medical assistance program authorized by Title XIX of the Social Security Act, 42 US.C. §§ 1396 et seq., and regulations thereunder, as administered in Florida by the Agency. "Directed Payment Program (DPP)," pursuant to the General Appropriation Act, Laws of Florida 2021-111, is the program that provides direct supplemental payments to eligible public and private entities that provide inpatient and outpatient services to Medicaid managed care recipients. A. GENERAL PROVISIONS Per Senate Bill 2500, the General Appropriations Act of State Fiscal Year 2021-2022, passed by the 2021 Florida Legislature, the Indian River County LPPF and the Agency agree that the Indian River County LPPF will remit IGT funds to the Agency in an amount not to exceed the total of $7,912,885. The Indian River County LPPF and the Agency have agreed that these IGT funds will only be used for the DPP program. 2. The Indian River County LPPF will return the signed LOA to the Agency. 3. The Indian River County LPPF will pay IGT funds to the Agency in an amount not to exceed the total of $7,912,885. The Indian River County LPPF will transfer payments to the Agency in the following manner: Per Florida Statute 409.908, annual payments for the months of July 2021 through June 2022 are due to the Agency no later than October 31, 2021 unless an altemative plan is specifically approved by the agency. b. The Agency will bill the Indian River County LPPF when payment is due. 4. The Indian River County LPPF and the Agency agree that the Agency will maintain necessary records and supporting documentation applicable to health services covered by this LOA in accordance with public recons laws and established retention schedules. a. AUDITS AND RECORDS Indian River County LPPF agrees to maintain books, records, and documents (including electronic storage media) pertinent to performance under this LOA in Indian River County LPPF_Region 9_DPP LOA_SFY 2021-22