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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 2025, by and between Indian River County LPPF (the "IGT Provider") on <br />behalf of Region 9, and the State of Florida, Agency for Health Care Administration (the <br />"Agency"), for good and valuable consideration, the receipt and sufficiency of which are <br />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 U.S.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 />2025-198, 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 />1. Per Senate Bill 2500, the General Appropriations Act of State Fiscal Year 2025-2026, <br />passed by the 2025 Florida Legislature, the Indian River County LPPFGT Provider and <br />the Agency agree that the IGT Provider will remit IGT funds to the Agency in an amount <br />not to exceed the total of $24,219,674.00 . The IGT Provider and the Agency have agreed <br />that these IGT funds will only be used for the DPP program. <br />2. The IGT Provider will return the signed LOA to the Agency. <br />3. The IGT Provider will pay IGT funds to the Agency in an amount not to exceed the total <br />of $24,219,674.00. The IGT Provider will transfer payments to the Agency in the <br />following manner: <br />a. Per Florida Statute 409.908, annual payments for the months of July 2025 <br />through June 2026 are due to the Agency no later than October 31, 2025, 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 agrees 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 />i. The IGT Provider agrees to maintain books, records, and documents (including <br />Indian River County LPPF _Region 9—DPP LOA_SFY 2025-26 <br />