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HomeMy WebLinkAbout2021-145Directed 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 accordance with generally accepted accounting procedures and practices, which sufficiently and properly reflect all revenues and expenditures of funds provided. ii. Indian River County LPPF agrees to assure that these records shall be subject at all reasonable times to inspection, review, or audit by state personnel and other personnel duly authorized by the Agency, as well as by federal personnel. iii. Indian River County LPPF agrees to comply with public record laws as outlined in section 119.0701, Florida Statutes. b. RETENTION OF RECORDS i. The Indian River County LPPF agrees to retain all financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to performance under this LOA for a period of six (6) years after termination of this LOA, or if an audit has been initiated and audit findings have not been resolved at the end of six (6) years, the records shall be retained until resolution of the audit findings. ii. Persons duly authorized by the Agency and federal auditors shall have full access to and the right to examine any of said records and documents. iii. The rights of access in this section must not be limited to the required retention period but shall last as long as the records are retained. c. MONITORING i. Indian River County LPPF agrees to permit persons duly authorized by the Agency to inspect any records, papers, and documents of the Indian River County LPPF which are relevant to this LOA. d. ASSIGNMENT AND SUBCONTRACTS i. The Indian River County LPPF agrees to neither assign the responsibility of this LOA to another party nor subcontract for any of the work contemplated under this LOA without prior written approval of the Agency. No such approval by the Agency of any assignment or subcontract shall be deemed in any event or in any manner to provide for the incurrence of any obligation of the Agency in addition to the total dollar amount agreed upon in this LOA. All such assignments or subcontracts shall be subject to the conditions of this LOA and to any conditions of approval that the Agency shall deem necessary. 5. This LOA may only be amended upon written agreement signed by both parties. The Indian River County LPPF 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 LPPF 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. Indian River County LPPF_Region 9_DPP LOA_SFY 2021-22 7. Indian River County LPPF agrees the following provision shall be included in any agreements between Indian River County LPPF 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, 2021 through June 30, 2022 and shall be terminated June 30, 2022. 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, SPP Loga'l Intor Q,ve_rnraq Trema srs Fri- ram,/ Aount Sarre Fi_scal.Ye_tar, ZQ140 Year One DPP IGTs $7,912,885 'T�oFundin $71912,885' 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 LPPF SIGNED BY: oseph E. Flescher TITLE: Chairman DATE: September 21, 2021 ANE) !_ "y By 1-0 t'•G U1tsJ Y ATE OF FLORIDA, AGENCY FOR ALTH CARE ADMINISTRATI N —r•.l�ri�. E: �!✓fR COU��ty •'fiITLE: Indian River County LPPF_Region 9—DPP LOA SFY 2021-22 DATE: 101 1 t-1 ( -�ba 1 Attest: Jeffrey R. Smith, Clerk of Cir it Court and Co ptrolier l Oeputy clerk IGT Provider Name: Health Care Provider Name: IGT Amount: State Fiscal Year Ending: Interaovernmental Transfers Questionnaire Indian River County N/A $7,912,885 6/30/2022 A TRUE COPY CERTIFICATION ON LAST PAGE J.R. SMITH. CLERK 1. What type of governmental entity is your organization considered? (county, city, hospital taxing district, or other) County If other, please explain 2. Does your organization have a relationship with the provider for which you contribute IGTs as named in the preamble of the enclosed Letter of Agreement (LOA)? No If yes, please describe your relationship, including services provided to/by the provider to/by the organization and any other financial transactions between the provider and the organization. 3. Please describe the source of the IGT funding for your organization, including whether the source is from a tax, a provider donation, or other funds. Provide the amount of funding from each source. Source Amount Special Assessment $ 7,912,885 If other, please explain a. Verify whether the funds are public funds as defined by 42 CFR § 433.51, and exclude any federal funds. Yes If no, please explain 4. Does your organization have taxing authority? Yes 5. If the source of IGT funding is from taxes, please answer the following questions: a. Is the tax a state, county, city, or hospital district tax? County f other, please explain h What entities are taxed? c. Wr d. Wl Jcensed non-public hsopitals in Indian River County A is the tax structure (i.e. property tax, percentage of revenue, assessment, etc.)? >pecial assessment t is the amount or percent or the tax .10% of Net Patient Revenue ,. TRUE COPY ERTIFICATION ON LAST PAGE .. SMITH, CLERK e. Does at least 85% of the burden of the tax revenue fall on health care providers as defined in 42 CFR §433.55? (Provide the total tax revenue and the health care provider tax burden) If so, please answer the following questions: Amount otal Tax Burden $ 8,846,336 iealthcare Provider Tax Burden I uu.uu"/o i) Is the tax broad based? A broad based tax can be defined as a tax that is imposed on at least all health care items or services in the class or providers of such items or services furnished by all non -Federal, non-public providers in the State, and is imposed uniformly, pursuant to 42 CFR § 433.68. Yes no, please explain A TRUE COPY CERTIFICATION ON LAST PAGE J.R. SMITH, CLERK ii) Is the tax uniform across all entities being taxed? Based on 42 CFR § 433.68, a health care - related tax will be considered to be imposed uniformly even if it excludes Medicaid or Medicare payments (in whole or in part), or both; or in the case of health care -related tax based on revenue or receipts with respect to a class of items or services, if it excludes either Medicaid or Medicare revenue with respect to a class of items or services, or both. The exclusion of Medicaid revenue must be applied uniformly to all providers being taxed. Yes If no, please explain iii) Is the tax generally redistributive and a waiver of the broad-based or uniform tax requirement was granted in accordance with 42 CFR §433.68(e)? No If no please explain No waiver was requested iv) Does the tax program comply with the hold harmless provisions included in 42 CFR § 433.68(f)? Yes If no, please explain v) Does every tax paying entity receive a supplemental payment equal to or exceeding its tax cost? If yes, please explain The County is not involved in the distribution of funds following federal match. The County is not in a position to speak to the ultimate distribution to hospitals from the managed care organizations. 6. Please answer the following regarding provider funds received from the healthcare entity and/or other health care entities. a. Are provider voluntary payments or in-kind services received by the organization as defined in 42 CFR § 433.52? No How much of the organization's revenue is received from provider -related donations (Provide the total revenue and the provider -related donation amounts)? Amount Total Revenue $ - Provider Related Donations $ - c. Do individual provider donations exceed $5,000 per year or $50,000 per year for a health care organizational entity? No If yes, please list the provider and payment amount. , iArL Of FLORIDA iN01AN RCOUNTY THIS 18 O RTIFY THAT THI818 &TRUE AND CORRECT COPAEAE E ORIGION FI N 8 8 I . RK JEFFR NAL R BY .C. DATE l G Provider Name Funding Source Amount d. Does any portion of the provider donation constitute as a "bona fide donation" pursuant to 42 CFR § 433.54? 42 CFR § 433.54 requires donations will not be returned to the individual provider, the provider class, or related entity under a hold harmless provision. e. Is there an agreement between the IGT provider and the health care entity? If so, please specify whether the agreement is written and provide the details. No 7. Were funds utilized for the IGT specifically appropriated by the organization's board? No If yes, provide the board minutes and date of the appropriation. I Joseph E. Flescher certify that the statements and information contained in this submittal are true, accurate, and complete. •,'....h.Mlss gnatt re of Office or Administrator Joseph E. Flescher, Chairman =?o .• oQ�i Title •.9,y�/, .1 .�� •> ,•,�ER COU@�� September 21, 2021 <' Date Attest: Jeffrey R. Smith, Clerk of Circuit Court and Comptroller Deputy Clerk APPR-OkIED AS 'fin FORM ANLL) L.&t::AL SUFFICIENCY