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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />Directed Payment Program Letter of Agreement <br />THIS LETTER OF AGREEMENT (LOA) is made and entered into in duplicate on the <br />day of 2023, by and between (the "Indian River County LPPF") on behalf of Region <br />9, and the State of Florida, Agency for Health Care Administration (the "Agency"), for good <br />and valuable consideration, the receipt and sufficiency 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. IGTs 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 />"Directed Payment Program (DPP)," pursuant to the General Appropriation Act, Laws of Florida <br />2021-156, is the program that provides direct supplemental payments to eligible public and private <br />entities that provide inpatient and outpatient services to Medicaid managed care recipients. <br />A. GENERAL PROVISIONS <br />Per Senate Bill 2500, the General Appropriations Act of State Fiscal Year 2023-2024, <br />passed by the 2023 Florida Legislature, the Indian River County LPPF and the Agency <br />agree that the Indian River County LPPF will remit IGT funds to the Agency in an amount <br />not to exceed the total of $3,005,374.88. The Indian River County LPPF and the Agency <br />have agreed that these IGT funds will only be used for the DPP program. <br />2. The Indian River County LPPF will return the signed LOA to the Agency. <br />3. The Indian River County LPPF will pay IGT funds to the Agency in an amount not to <br />exceed the total of $3,005,374.88. The Indian River County LPPF will transfer <br />payments to the Agency in the following manner: <br />a. Per Florida Statute 409.908, annual payments for the months of July 2023 <br />through June 2024 are due to the Agency no later than October 31, 2023, unless <br />an alternative plan is specifically approved by the agency. <br />b. The Agency will bill the Indian River County LPPF when payment is due. <br />4. The Indian River County LPPF and the Agency agree that the Agency will maintain <br />necessary records and supporting documentation applicable to health services covered <br />by this LOA in accordance with public records laws and established retention schedules. <br />a. AUDITS AND RECORDS <br />Indian River County LPPF agrees to maintain books, records, and documents <br />(including electronic storage media) pertinent to performance under this LOA in <br />Indian River County LPPF_Region 9 _DPP LOA_SFY 2023- <br />24 <br />