TO: Honorable Mayor & Members of the North Port Commission
FROM: Peter D. Lear, CPA, CGMA, City Manager
TITLE: Approval of Medicaid Managed Care (MCO) Supplemental Program Letters of Agreement with Florida Community Care, Staywell and Vivida Health
Recommended Action
Approve the Medicaid Managed Care (MCO) Supplemental Program Letters of Agreement with Florida Community Care, Staywell and Vivida Health and to authorize the City Manager to execute future Medicaid Managed Care Supplemental Program Letters of Agreement provided there are no substantive changes to the provided agreements drafted and provided by the Agency for Health Care Administration (AHCA)
Background Information
Over the past four years, the Medicaid Fee For Service (FFS) Public Emergency Medical Transportation (PEMT) Program has generated over $100 Million in additional federal dollars to Florida’s Public Emergency Medical Service (EMS) provider community. In the State’s Fiscal Year (SFY) 2018-19, this program yielded $27.9 Million in additional federal funding for providers and this number will continue to grow as additional public EMS providers participate in the program.
Starting in SFY 2019-20 there is an additional benefit to participating in the FFS PEMT program, which is that providers will be able to participate in the Medicaid Managed Care (MCO) Supplemental Payment Program. The MCO program was recently approved by the Center for Medicare & Medicaid Services (CMS) and is expected to generate $33.7 million in additional federal funding for this fiscal year. The MCO program has a different funding mechanism than the FFS program. This funding mechanism is known as an Intergovernmental Transfer, or IGT. What this means for providers is that in order for the additional funding to be generated, the provider community will need to transfer specific dollar amounts determined by the State Medicaid agency, Agency for Health Care Administration (AHCA), and this allows AHCA to draw down the additional Federal funding. These IGT amounts will be returned to providers along with the additional federal dollars in the form of pass through payments made by the Managed Care Organizations.
The City of North Port has 7 MCOs in our region that each require an agreement for the pass-through payments to be completed. Currently, 3 of the 7 have returned partially executed agreements. A total of $123,887.66 will be transferred to the City of North Port in FY 19/20 when all 7 agreements are fully executed.
The City Attorney has approved to form and content.
Strategic Plan
Create and sustain a safe and healthy environment for residents and visitors of North Port.
Financial Impact
Additional General Fund revenue of $123,887.66 for FY 19/20.
Procurement
Vendor Information:
Attachments:
1. Letter of Agreement Florida Community Care (MCO)
2. Letter of Agreement Vivida Health (MCO)
3. Letter of Agreement Staywell-Wellcare (MCO)
Prepared by: Nick Herlihy, Division Chief Administration
Department Director: Scott Titus, Fire Chief