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Home My WebLink About2026-153A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK Directed Payment Program Letter of Agreement THIS LETTER OF AGREEMENT ("LOA") is made and entered into in duplicate on the day of 2026, by and between Indian River County LPPF (the "IGT Provider") on behalf of Region F, and the State of Florida, Agency for Health Care Administration (the "Agency"), for good and valuable consideration, the receipt and sufficiency of which is acknowledged. DEFINITIONS "Directed Payment Program (DPP)," pursuant to the General Appropriation Act, Laws of Florida 2026-232, 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. "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 U.S.C. §§ 1396 et seq., and regulations thereunder, as administered in Florida by the Agency. A. GENERAL PROVISIONS 1. Per House Bill 5001, the General Appropriations Act of State Fiscal Year 2026-2027, passed by the 2026 Florida Legislature, the IGT Provider and the Agency agree that the IGT Provider will remit IGT funds to the Agency in an amount not to exceed the total of $1.00. The IGT Provider and the Agency have agreed that these IGT funds will only be used for the DPP program. 2. The IGT Provider must return the signed LOA to the Agency no later than October 1, 2026. 3. The IGT Provider will pay IGT funds to the Agency in an amount not to exceed the total of $1.00. The IGT Provider will transfer payments to the Agency in the following manner: Per Florida Statute 409.908, annual payments for the months of July 2026 through June 2027 are due to the Agency no later than October 31, 2026, unless an alternative plan is specifically approved by the agency. b. The Agency will bill the IGT Provider when payment is due. 4. The IGT Provider 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 records laws and established retention schedules. Indian River County LPPF_Region F _DPP L0A_SFY 2026-27 A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK a. AUDITS AND RECORDS i. The IGT Provider agrees to maintain books, records, and documents (including electronic storage media) pertinent to performance under this LOA in accordance with generally accepted accounting procedures and practices, which sufficiently and properly reflect all revenues and expenditures of funds provided. The IGT Provider 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. The IGT Provider agrees to comply with public record laws as outlined in section 119.0701, Florida Statutes. b. RETENTION OF RECORDS The IGT Provider 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. The IGT Provider agrees to permit persons duly authorized by the Agency to inspect any records, papers, and documents of the IGT Provider which are relevant to this LOA. d. ASSIGNMENT AND SUBCONTRACTS The IGT Provider 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 IGT Provider 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. Indian River County LPPF_Region F _DPP LOA_SFY 2026-27 A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK 6. The IGT Provider 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. 7. The IGT Provider agrees the following provision shall be included in any agreements between the IGT Provider 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, 2026, through June 30, 2027, and shall be terminated September 30, 2027, which includes the states certified forward period. 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. 10. The IGT Provider agrees to indemnify and hold harmless the Agency against any and all liability related to a finding by CMS or the federal government that the IGT transfer, or source of funds transferred, did not comply with the Medicaid state plan, Title XIX of the Social Security Act, or any state or federal regulations or policies implementing Title XIX of the Social Security Act, including but not limited to Section 1903(w) of the Social Security Act; 42 C.F.R. Part 433, subpart B; and Centers for Medicare & Medicaid Services' ("CMS") State Medicaid Director Letter #14-004 (May 9, 2014). This indemnification would extend to any completed, actual, pending, or threatened action, suit, claim, or proceeding brought by CMS or the federal government based upon a demand or disallowance of any amount, including amounts relating to supplemental payments. The IGT Provider shall timely reimburse the Agency's reasonable legal fees and costs with respect to any proceeding related to whether the IGT transfer, or source of funds transferred, violated the Medicaid state plan, Title XIX of the Social Security Act, or any state or federal regulations or policies implementing Title XIX of the Social Security Act. The IGT Provider will also be liable and financially responsible in the event that a demand or disallowance of any amount is found to be due and owing on this basis. Indian River County LPPF_Region F _DPP LOA_SFY 2026-27 STATE OF FLORIDA N OIAN RIVER COUNTY THIS IS TO CERTIFY THAT THIS IS A TRUE AND CORRECT COP jTHEORIGINAL FILE IN IS OFFICE. AN L. C KBYqD.C. DATE DPP Local Intergovernmental Transfers Program / Amount State Fiscal Year 2026-2027 Estimated IGTs $1.00 Total Funding Not to Exceed $1.00 WITNESSETH: IN WITNESS WHEREOF, the parties have caused this 4 -page Letter of Agreement to be executed by their undersigned officials as duly authorized. "�pR1Ml5s`` INDIAN RIVER COUNTY LPPFIIo* • `��s: STATE OF FLORIDA, AGENCY FOR * HEALTH CARE ADMINISTRATION SIGNED BY: NAME: Dervl Loar TITLE: Chairman DATE: September 15. 2026 Attest: Ryan L. Butler, Clerk of Circuit Court and Comptroller By: QI /odn Deputy Clerk .dSIGNED BY: NAME: Stephanie Scanlon TITLE: ADS for Medicaid Finance and Analytics DATE: Indian River County LPPF_Region F _DPP LOA_SFY 2026-27