Agenda 07/14/2020 Item #16E 1 (Accept Direct Payments from Statewide Medicaid Managed Care (SMMC) Program07/14/2020
EXECUTIVE SUMMARY
Recommendation for EMS to accept direct payments from the program named Statewide Medicaid
Managed Care (SMMC), a supplemental Medicare payment program, in the amount up to
$620,090.36 and to authorize Chairman to sign seven (7) Public Emergency Medical Transportation
Uniform Increase Agreements with Florida Community Care, LLC, Humana Medical Plan, Inc.,
Molina Healthcare of Florida, Staywell, Sunshine State Health Plan, Inc., Vivida Health and Clear
Health Alliance, and to approve the necessary budget amendments.
OBJECTIVE: To accept direct payments in the amount of $620,090.36 from the program named
Statewide Medicaid Managed Care (SMMC) to be used for Collier County Emergency Medical Services
operations.
BACKGROUND: In the 2019 General Appropriations Act, the Florida Legislature directed the Agency
for Health Care Administration (Agency) to make direct payments to qualifying Public Emergency
Medical Transportation (PEMT) providers for services under the Statewide Medicaid Managed Care
(SMMC) program. The Agency submitted the 438.6(c) Pre-print uniform increase proposal to the Centers
for Medicare and Medicaid Services (CMS) on August 30, 2019. On April 8th, the Agency for Health
Care Administration (AHCA) received approval from the Centers for Medicare & Medicaid Services
(CMS) for a Medicaid Managed Care (MCO) Public Emergency Medical Transportation (PEMT)
supplemental payment program. This program allows for additional payments to medical providers for
transports provided to Medicaid enrollees in the state of Florida.
The PEMT program provides supplemental payments to eligible public entities that meet specific
requirements and provide emergency medical transportation to Medicaid recipients. Collier County
Emergency Medical Services has been identified as a PEMT provider and therefore is eligible for these
payments. Medicaid payments are made to providers based on a set rate, which is less than the fees
charged, leaving the provider with a balance that cannot be billed to the patient and is ultimately written
off. This program was created to help offset the loss of revenue. Each PEMT provider will receive their
estimated allocation during the course of the year which is subject to adjustment based on utilization. A
reconciliation will be performed by ACHA annually which may adjust payments made by the SMMC
program.
CONSIDERATIONS: The State will provide SMMC with each participating PEMT provider’s
allocation. Collier County’s projected amount is $620,090.36. The payments are made through an
increase to the Medicaid rate. The increase is calculated based on prior year transports as well as
projections for the current year’s population based on historical utilization. These funds, which are
passed through The Agency for Health Care Administration (ACHA), made available by the Federal
Government, will be available to the SMMC health plans, to distribute quarterly to qualified PEMT
providers. This was approved by CMS (Center for Medicare and Medicaid Services).
The SMMC health plans are required to have an agreement in place with the PEMT providers in their
corresponding regions before payments are disbursed. Collier County EMS is located in Medicaid region
eight. In region eight there are seven SMMC health plans that require a Public Emergency Medical
Transportation Uniform Increase Agreement, which is an agreement that allows the same (uniform)
increase in the rate that is paid out on each member enrolled in that managed care plan. The seven SMMC
health plans in region eight that Collier County EMS is required to sign agreements with include: Florida
Community Care, Humana Medical Plan, Molina Healthcare, Staywell, Sunshine Health, Vivida Health
and Simply Healthcare.
16.E.1
Packet Pg. 2394
07/14/2020
FISCAL IMPACT: A Budget Amendment is needed to appropriate the $620,090.36 within EMS Fund
490.
LEGAL CONSIDERATIONS: This item is approved for form and requires majority vote for approval.
-JAB
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting from this
action.
RECOMMENDATION: That the Board of County Commissioners approve EMS to accept direct
payments from the program named Statewide Medicaid Managed Care (SMMC), a supplemental
Medicare payment program, in the amount up to $620,090.36 and to authorize Chairman to sign seven (7)
Public Emergency Medical Transportation Uniform Increase Agreements with Florida Community Care,
LLC, Humana Medical Plan, Inc., Molina Healthcare of Florida, Staywell, Sunshine State Health Plan,
Inc., Vivida Health and Clear Health Alliance, and to approve the necessary budget amendments.
PREPARED BY: Erin Page, Accounting Supervisor, Emergency Medical Services Admin.
ATTACHMENT(S)
1. MCO regions Plans by regions and MCO contacts (PDF)
2. PEMT Uniform Increase Overview (PDF)
3. [LinkedX] Letters of Agreement (PDF)
16.E.1
Packet Pg. 2395
07/14/2020
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.1
Doc ID: 12538
Item Summary: Recommendation for EMS to accept direct payments from the program named
Statewide Medicaid Managed Care (SMMC), a supplemental Medicare payment program, in the amount
up to $620,090.36 and to authorize Chairman to sign seven (7) Public Emergency Medical Transportation
Uniform Increase Agreements with Florida Community Care, LLC, Humana Medical Plan, Inc., Molina
Healthcare of Florida, Staywell, Sunshine State Health Plan, Inc., Vivida Health and Clear Health
Alliance, and to approve the necessary budget amendments
Meeting Date: 07/14/2020
Prepared by:
Title: Accounting Technician – Emergency Medical Services
Name: Erin Page
06/02/2020 4:27 PM
Submitted by:
Title: Division Director - EMS Operations – Emergency Medical Services
Name: Tabatha Butcher
06/02/2020 4:27 PM
Approved By:
Review:
Administrative Services Department Michael Cox Level 1 Division Reviewer Completed 06/03/2020 7:53 AM
Emergency Medical Services Tabatha Butcher Additional Reviewer Completed 06/11/2020 9:07 AM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 06/24/2020 8:52 AM
County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 06/29/2020 3:57 PM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 06/29/2020 4:36 PM
Office of Management and Budget Laura Wells Additional Reviewer Completed 06/30/2020 10:24 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 06/30/2020 2:09 PM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 07/05/2020 7:54 PM
Board of County Commissioners MaryJo Brock Meeting Pending 07/14/2020 9:00 AM
16.E.1
Packet Pg. 2396
16.E.1.b
Packet Pg. 2397 Attachment: MCO regions Plans by regions and MCO contacts (12538 : Public Emergency Medical Transportation Uniform Increase
STATEWIDE MEDICAID MANAGED CARE (SMMC) HEALTH PLANS (2018-2023)
REGIONAL
ROLLOUT
SCHEDULE
REGION
AETNA
BETTER
HEALTH
COMMUNITY
CARE PLAN
FLORIDA
COMMUNITY
CARE
HUMANA
MEDICAL
PLAN
LIGHTHOUSE
HEALTH
PLAN
MIAMI
CHILDREN’S
MOLINA
HEALTHCARE PRESTIGE SIMPLY
HEALTHCARE STAYWELL SUNSHINE
HEALTH UNITEDHEALTHCARE VIVIDA
HEALTH
PHASE 32/1/20191 FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
LIGHTHOUSE
HEALTH PLAN
MMA
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
2 FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
LIGHTHOUSE
HEALTH PLAN
MMA
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
3 FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
UNITEDHEALTHCARE
COMP
4 FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
UNITEDHEALTHCARE
COMP
PHASE 21/1/20195 FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
SIMPLY
HEALTHCARE
COMP
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
6 AETNA
BETTER
HEALTH
COMP
FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
SIMPLY
HEALTHCARE
COMP
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
UNITEDHEALTHCARE
COMP
7 AETNA
BETTER
HEALTH
COMP
FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
SIMPLY
HEALTHCARE
COMP
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
8 FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
MOLINA
HEALTHCARE
COMP
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
VIVIDA
HEALTH
MMA
PHASE 112/1/20189 FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
MIAMI
CHILDREN’S
MMA
PRESTIGE
MMA
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
10 COMMUNITY
CARE PLAN
MMA
FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
SIMPLY
HEALTHCARE
COMP
SUNSHINE
HEALTH
COMP
11 AETNA
BETTER
HEALTH
COMP
FLORIDA
COMMUNITY
CARE
LTC+
HUMANA
MEDICAL PLAN
COMP
MIAMI
CHILDREN’S
MMA
MOLINA
HEALTHCARE
COMP
PRESTIGE
MMA
SIMPLY
HEALTHCARE
COMP
STAYWELL
COMP
SUNSHINE
HEALTH
COMP
UNITEDHEALTHCARE
COMP
Comp = Comprehensive Plan MMA = Managed Medical Assistance Plan LTC+ = Long-Term Care Plus Plan This chart includes plans who have been awarded an 2018-2023 contract, as of September 28, 2018, who will begin operation 12/1/2018 through 2/1/2019. As of 02-13-2019
16.E.1.b
Packet Pg. 2398 Attachment: MCO regions Plans by regions and MCO contacts (12538 : Public Emergency Medical
SMMC SPECIALTY PLANS
(2018-2023)
SMMC DENTAL PLANS
(2018-2023)
REGIONAL
ROLLOUT
SCHEDULE
REGION
CHILDREN’S MEDICAL
SERVICES PLAN –
CHILDREN WITH
CHRONIC CONDITIONS
CLEAR HEALTH
ALLIANCE –
HIV/AIDS
MAGELLAN
COMPLETE CARE –
SERIOUS MENTAL
ILLNESS (SMI)
STAYWELL –
SERIOUS MENTAL
ILLNESS (SMI)
SUNSHINE HEALTH –
CHILD WELFARE DENTAQUEST LIBERTY MCNA DENTAL
PHASE 32/1/20191 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
2 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
3 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
4 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
MAGELLAN
COMPLETE CARE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
PHASE 21/1/20195 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
MAGELLAN
COMPLETE CARE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
6 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
7 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
MAGELLAN
COMPLETE CARE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
8 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
PHASE 112/1/20189 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
10 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
11 CHILDREN’S MEDICAL
SERVICES PLAN
SPEC
CLEAR HEALTH ALLIANCE
SPEC
STAYWELL
SPEC
SUNSHINE HEALTH
SPEC
DENTAQUEST
DEN
LIBERTY
DEN
MCNA DENTAL
DEN
Spec = Specialty Plan Den = Dental Plan As of 02-13-2019This chart includes plans who have been awarded an 2018-2023 contract, as of September 28, 2018, who will begin operation 12/1/2018 through 2/1/2019.
16.E.1.b
Packet Pg. 2399 Attachment: MCO regions Plans by regions and MCO contacts (12538 : Public Emergency Medical
SMMC Plan Contact: Provider Networks
Updated 3/30/2020
Plan Name Provider Relations Contact
Aetna Better Health Susan Waldman
Email: FLMedicaidProviderRelations@aetna.com
Phone: 1-800-441-5501
Children’s Medical Services Plan Barbara Mason
Email: Barbara.Mason@wellcare.com
Phone: 407-551-3238
Community Care Plan Remon Walker
Email: rwalker@ccpcares.org
Phone: 954-622-3308
Florida Community Care Grace Rodriguez
Email: grodriguez@fcchealthplan.com
Phone: 1-833-322-7526 ext.106494
Humana LTC provider contact:
Ann Jamke
Email: LTCProviderrelations@humana.com
Phone: 561-860-8660
MMA Provider contact:
Sonia Rozada
Email: FLMedicaidProviderRelations@humana.com
Phone: 305-626-5006 / 305-626-5266
Lighthouse Carrie Skeen
Email: providerrelations@lighthousehealthplan.com
Phone: 1-844-243-5181
Magellan Complete Care Dione Prinzi Sadr
Email: sadrd@magellanhealth.com
Phone: 407-374-5540
Miami Children’s Health Email : ProviderServices@MiamiChildrensHealthPlan.com
Phone: 1-844-243-5188
Fax: 1-888-843-3938
Molina Healthcare Lisa Schwendel
Email: Lisa.Schwendel@MolinaHealthCare.Com
Phone: 1-866-422-2541 ext. 223594
Prestige Health Choice Lillian Morales
LBMorales@prestigehealthchoice.com
561-282-4222
Simply Healthcare LTC provider contact:
Renee Thomas
Email: renee.thomas@amerigroup.com
Phone: 954-308-9410
General LTC inquiry: ltcprovrelations@amerigroup.com
MMA provider contact:
Dixie Hollis
Email: DHollis@simplyhealthcareplans.com
Phone: 813-425-8017
Staywell Barbara Mason
Email: Barbara.Mason@wellcare.com
Phone: 407-551-3238
16.E.1.b
Packet Pg. 2400 Attachment: MCO regions Plans by regions and MCO contacts (12538 : Public Emergency Medical Transportation Uniform Increase
SMMC Plan Contact: Provider Networks
Updated 3/30/2020
Sunshine Health Mark Barrett
Email: sunshinecontracting@centene.com
Phone: 1-866-595-8116
United Healthcare Felix Gonzalez
Email: felix_m_gonzalez@uhc.com
Phone: 407-659-6965
Vivida Health Stacey Lau
Email: providerrelations@vividahealth.com
Phone: 1-844-243-5175
DENTAL
Plan Name Provider Relations Contact
DentaQuest Vanessa Guerrero
Email: FloridaProviders@DentaQuest.com
Phone: 1-877-468-5581
LIBERTY Betty Gilbert
Email: prinquiries@libertydentalplan.com
Phone: 1-888-352-7924 ext. 393
MCNA Mercedes Linares
Email: prdepartment@mcna.net
Phone: 1-855-698-6262
16.E.1.b
Packet Pg. 2401 Attachment: MCO regions Plans by regions and MCO contacts (12538 : Public Emergency Medical Transportation Uniform Increase
Florida Division of Medicaid
AHCA – MPF
April 14, 2020
Public Emergency Medical Transportation Uniform Increase
Background:
In the 2019 General Appropriations Act, the Florida Legislature directed the Agency for Health
Care Administration (Agency) to make direct payments to qualifying Public Emergency Medical
Transportation (PEMT) providers for services under the Statewide Medicaid Managed Care
(SMMC) program. The Agency submitted the 438.6(c) Pre-print uniform increase proposal to the
Centers for Medicare and Medicaid Services (CMS) on August 30, 2019, and received approval
from CMS April 8, 2020. This payment will be similar to the existing unform increases for the
Medical Schools and Cancer Hospitals.
Qualifying Providers:
The PEMT program provides supplemental payments to eligible public entities that meet
specific requirements and provide emergency medical transportation to Medicaid recipients.
Please see the attached exhibit for a list of qualified providers and their contact information for
state fiscal year 2019-20.
Distribution:
The direct payment must be made through a uniform increase calculated as a supplemental per
member per month. This amount will be calculated from actuarially sound projections of
supplemental support for PEMT providers under the State’s fee-for-service program as well as
projections for the current year’s managed care population based on historical utilization. These
funds will be available to the SMMC health plans to distribute quarterly to qualified PEMT
providers. The State will provide the SMMC health plans with each participating PEMT
provider’s allocation of the aggregate projected payment amount.
Each PEMT provider will receive their estimated allocation during the course of the year if the
actual utilization is met within a maximum of +1% and a minimum of -5% of the projected
utilization. The threshold reconciliation will be performed by the Agency annually. If the
utilization exceeds 1% above the projected threshold, the SMMC health plans must continue to
make payments at the originally contracted rates. If the utilization falls more than 5% below the
projected threshold, the PEMT provider must return the uniform increase payment amounts
above the contracted rate to the Agency.
Next Steps:
The SMMC health plans are required to have an agreement in place with the PEMT providers in
their corresponding regions before payments are disbursed. The Agency will also amend the
SMMC health plans’ contracts to include the new uniform increase.
An example agreement is attached as an exhibit. This agreement is acceptable, but is not the
only agreement that may be used for these purposes.
16.E.1.c
Packet Pg. 2402 Attachment: PEMT Uniform Increase Overview (12538 : Public Emergency Medical Transportation Uniform Increase Agreements)
Letter 01 Agreement
This Letter' of Agreement ("LOA"} is made and entered into on the 1st of May, 2020 by and between Collier
Coun y EMS (Government Owned Emergency Medical Service (EMS) Provider) and WellCare of Florida, Inc.
d/b/a Staywell, a managed care organization operating the Statewide Medicaid Managed Care plan and the
Children's Medical Services plan (Medicaid Managed Care Organization (MCO)) (herein referred to collectively
as "Parties").
WHEREAS, the Medicaid MCO has been awarded a contract by the Agency for Health Care
Administration (AHCA) to deliver managed care services to Medicaid enrollees under an 1115 Managed Medical
Assistance Waiver (the "Waiver") in Region 8 ,which includes Charlotte,, Collier, Desoto, Glades, Hendt'y, Ue
and Sarasota County where Government Owned EMS Provider is located and/or operates;
WHEREAS, AHCA has approved the Government Owned EMS Provider as a qualifying entity and
provldes out of network emergency medical services to MCO enrollees in Region 8 on an as needed basis, when
the transport and treatment is appropriate; and
WHEREAS, the Centers foi• Medicare and Medicaid Services ("CMS"} approved section 438.E directed
payments based on the establishment of a uniform increase to be paid to qualifying Government Owned EMS
Providers for the provision of emergency medical services to Medicaid eligible persons enrolled in managed cair,
organizations pursuant to the Waiver, which includes the Medicaid MCO.
NOW THEREFORE, Government Owned EMS Provider and the Medicaid MCO do hereby agree to the
following:
1 Government Owned EMS Provider agrees to make eixiergency medical services available to MCO's
Medicaid enrollees on an as needed basis, when the transport and treatment is appropriate,
2, Medicaid MCO shall receive per member per month section 438.E directed payments for care and
treatment provided by the Government Owned EMS Provider, Which the Medicaid MCO sha11 timely
remit to the Government Owned EMS Provider in accordance with AHCA's contractual requirements,
3. Contact information for the parties is as follows:
Name: Tabatha Butcher
Title: Chief EMS
Phone* 239-252-3780
Email: Tabatha.Buficher �r colliei•countyfl.gov
Name: Janette White
Title: Sr. Manager
Phone: 813-532"7332
Email: Janette. white ct Wellcare.coin
4. The Parties agree any modification to the LOA shall be in the same form, namely the
exchange of signed copies of a revised LOA.
S. This LOA covers the period of October 1, 2019 through June 30, 2024 unless terminated
sooner by the termination of section 438.d directed payments.
IN WITNESS WHEREOF, the Parties have duly executed this LOA on the day and
written. Each party represents that; (i) it has the authority to enter into this Agreement;
individual signing this Agreement on its behalf is authorized to do so.
GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER
Burt L. Saunders, Chairman
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
7/ 14/2020
DATE
MEDICAID MANAGED CARE ORGANIZATION
Mark J. Fehring, VP Field Network Management
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
DATE
ATTEST
CRYSTAL K, KIN7,EL, CLERK
BY;
Approved As to form anti Ir�.ility
yeas above first
and (ii) that the
Assistaijt County Atturncy .�'dw
CA
CAO
better of Agreement
This I..etter of Agreement {"LOA") is made and entered into on the 1 st day of May, 2020 by a110
between Collier County Emergency Medical Services (Government Owned Emergency
Medicl Service (EMS} Provider} anssurai�Ce
d Best Care A,, LLC dll,/a Viyida1ealth
CA
(Medicaid Managed Care Organization (MCO)) (herein referred to collectively as "Parties").
WHEREAS, the Medicaid MCO has been awarded a contract by the Agency for Health
,are Administration (AHCA) to deliver managed care services to Medicaid enrollees under an
115 Managed Medical Assistance Waiver (the "Waiver") in Region .8_, which includes
Charlotte, Collier, Desoto, Glades, Hendrv, Lee and Sarasota County where Government
Owned EMS Provider is located andlor operates;
WHEREAS, AHCA has approved the Government Owned EMS Provider as a qualifying
entity and provides out of network emergency medical services to MCO enrollees in Region 8 on
an as needed basis, when the transport and treatment is appropriate; and
WHEREAS, the Centers far Medicare and Medicaid Services {"CMS"} approved section
438.6 directed payments based on the establishment of a uniform increase to be paid to
qualifying Government Owned EMS Providers for the provision of emergency medical services
to Medicaid eligible persons enrolled in managed care organizations pursuant to the Waiver,
which includes the Medicaid MCO.
NOW THEREFORE, Government Owned EMS Provider and the Medicaid
MCO do hereby agree to the following:
1. Government Owned EMS Provider agrees to tnalce emergency medical services available
to MCO's Medicaid enrollees on an as needed basis, when the transport and treatment is
appropriate,
2, Medicaid MCO shall receive per member per month section 438.E directed payments for
care and treatment provided by the Government Owned EMS Provider, which the Medicaid
MCO shall timely remit to the Government Owned EMS Provider in accordance with
AHCA's contractual requirements.
3. Contact information for the parties is as follows:
Name: Tabatha Butcher
Title: Chief EMS
Phone :239-ZS2-378Q
Email:
Tabatha.Butcher tr CollierCountyFl.gov
Name; I{evin 1�. Dotson, FSA, MAAA
Title: Chief Financial Officer
Phone:239-343-1316
Email: Kenvin.dotson r�leehealth.org
4. The Patties agree any modification to the LOA shall be in the same form, namely the
exchange of signed copies of a revised LOA.
5. This LOA covets the period of October 1, 2019 through June 30, 2024 unless terminated
sooner by the termination of section 438.6 directed payments.
IN WITNESS WHEREOF, the Patties have duly executed this LOA on the day and year above
first written. Each party represents that: (i) it has the authority to enter into this Agreement; and
(ii) that the individual signing this Agreement on its behalf is authorized to do so.
GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER
Butt L. Saunders, Chairman
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
7/ 14/2020
DATE
MEDICAID MANAGED CARE ORGANIZATION
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
DATE
ATTEST
CRYSTAL IC. KINZEL, CLERIC
BY:
Approved as to form anti I�gality
O
Assistant County Attc>rury � �a\a
lob
C'�O
Letter of Agreement
This Letter of Agreement ("LOA") is made and entered into on the 1 st of May, 2020 by and between
Collier County EMS (Government Owned Emergency Medical Service (EMS) Provider) and Sunshine State
Health Plan, Inc., a managed care organization operating the Statewide Medicaid Managed Care plan and if
applicable, the Children's Medical Services plan (Medicaid Managed Care Organization (MCO)) (herein
referred to collectively as "Parties").
WI-IEREAS, the Medicaid MCO has been awarded a contract by the Agency for Health Care
Administration (AHCA) to deliver managed care services to Medicaid enrollees under an 1115 Managed
Medical Assistance Waiver (the "Waiver") in Region 8, which includes Charlotte, Collier, Desoto, Glades,
sawsHendry, Lee and Sarasota County where Government Owned EMS Provider is located and/or operates;
WHEREAS, AHCA has approved the Government Owned EMS Provider as a qualifying entity and
provides out of network emergency medical services to MCO enrollees in Region 8 on an as needed basis, when
the transport and treatment is appropriate; and
WHEREAS, the Centers for Medicare and Medicaid Services {"CMS"} approved section 438.6 directed
payments based on the establishment of a uniform increase to be paid to qualifying Government Owned EMS
Providers for the provision of emergency medical services to Medicald eligible persons enrolled in managed
care organizations pursuant to the Waiver, which includes the Medicaid MCO.
NOW THEREFORE, Gavernmetlt Owned EMS Provider and the Medicaid MCO do hereby agree to the
following:
1. Government Owned EMS Provider agrees to make emergency medical services available to MCO's
Medicaid enrollees on an as needed basis, when the transport and treatment is appropriate.
2, Medicaid MCO shall receive per member per month section 438.E directed payments for care and
treatment provided by the Government Owned EMS Provider, which the Medicaid MCO shall fiimely
remit to the Government Owned EMS Provider in accordance with AHCA's contractual requirements.
3. Contact information for the parties is as follows:
Name: Tabatha Butcher
Title: Chief of EMS
Phone: 239-252-3780
Email: Tabatha.Butche,tQ(coiiiercouiityfl.,�ov ,
To Health Plan at:
Attn: President I CEO
Sunshine State Health Plan, Inc.
1301 International Parkway, 4tE' floor
Sunrise, FL 33323
4, The Parties agree any modification to the LOA shall be in the same form, namely the exchange of
signed copies of a revised LOA. .
5. This LOA covers the period of October 1, 2017 through June 305 2024 unless ter'r111tlated sooner
by the termination of section 438.6 directed payments.
IN WI"I'NESS 1lVHEREOF, the Patties have duly execLited this LOA on the day atld year• above
first written. Each party represents that: (1) it has the authority to enter into this Agreement; and
that the individual signing this Agreement on its behalf is authorized to do so.
GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER
Butt L. Saunders, Chairman
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
7/14/2020
DATE
MEDICAID MANAGED CARE ORGANIZATION
Elizabeth M. Miller, President /CEO
NAME & TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
DATE
ATTEST
CRYSTAL K. KINZEL, CLERIC
BY:
Approved �s to form and Irhulity
Assistant County Attoniwy 5Y-
X.eUVI of Agreerne"t
This Letter of Agreement ("LOA") is made and entered into ozl the 15` day of May,by and
between Collier County EIVIS (Government Owned Emergency Medical Service (EMS}
Provider) and SIMPLY HEALTHCARE PLANS, INC. DBA CLEAR HEALTH ALLIANCE
(Medicaid Managed Care Organization (MCO)) (herein referred to collectively as "Parties").
WHEREAS, the Medicaid MCO leas been awarded a contract by the Agency for Health
.are Administration (AHCA) to deliver managed care services to Medicaid enrollees under an
11 1 S Managed Medical Assistance Waiver (the "Waiver") in Region 8 which includes
Charlotte, Collier, Desoto, Glades, Hendry, Lee and Sarasota County where Government
Owned EMS Provider is located and/or operates;
WHEREAS, AHCA leas approved the Government Owned EMS Provider as a qualifying
entity and provides out of network emergency medical services to MCO enrollees in Region 8 oil
an as needed basis, when the transport and treatment is appropriate; and
WHEREAS, the Center's fog• Medicare and Medicaid Services ("CMS") approved section
438.6 directed payments based on the establishment of a uniform increase to be paid to
qualifying Government Owned EMS Providers for the provision of emergency medical services
to Medicaid eligible persons enrolled in managed care organizations pursuant to the Waiver,
which includes the Medicaid MCO.
NOW THEREFORE, Government Owned EMS Provider and the Medicaid MCO
do hereby agree to the following;
1. Government Owned EMS Provider agrees to matte emergency medical services available
to MCO's Medicaid enrollees on an as needed basis, when the transport and treatment is
appropriate,
2. Medicaid MCO shall receive per member per month section 438.6 directed payments for
care and treatment provided by the Government Owned EMS Provider, which the Medicaid
MCO shall timely remit to the Government Owned EMS Provider in accordance with
AHCA's contractual requirements.
3. Contact information for the parties is as follows:
Name: Tabatha Butcher
Title: Chief EMS
Phone: 239-252-378�
Email:
"Tabatha.Butcher@CollierCountyFL.gov
Name: Barbara Morales
Title: Provider Network Manager
Phone: 950405-6136
Email:
bmorales t�simplyhealthcareplans.com
4. The Parties agree any modification to the LOA shall be in the same form, namely the
exchange of signed copies of a revised LOA.
5. This LOA covers the period of October 1, 2019 through June 30, 2024 unless terminated
sooner by the termination of section 438.6 directed payments.
IN WITNESS WHEREOF, the Parties have duly executed this LOA on the day and year above
first written. Each patty represents t11at: (i) it has the authority to enter into this Agreement; and
(ii) that the individual signing this Agreement on its behalf is authorized to do so.
GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER
Burt L. Saunders, Chait•man
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
7/ 14/2020
DATE
MEDICAID MANAGED CARE ORGANIZATION
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
DATE
ATTEST
CRYSTAL K. KINZEL, CLERK
F3Y:
Approved as to farm and legality
O
Assistutit County Atttirnry � ,����
9- aa•
Letter of AAVgreement
This Letter of Agreement ("LOA"} is made and entered into on the Xs# of NtaY, 220 by
and between Collier County EMS (Government Owned Emergency Medical Service
(EMS) Provider) and Molina Healthcare of Florida (Medicaid Managed Care Organization
(MCO) (herein referred to collectively as "Parties"),
WHEREAS, the Medicaid MCO has been awarded a contract by the Agency for Health
Care Administration (APICA) to deliver managed care services to Medicaid enrollees under an
i l l S Managed Medical Assistance Waiver (the "Waiver") in Region 8 , which includes
Charlotte, Collier, Desoto, Glades, Hendry, Lee and Sarasota County where Government
Owned EMS Provider is located and/or operates;
WHEREAS, AHCA has approved the Government Owned EMS Provider as a qualifying
entity and provides out of network emergency medical services to MCO enrollees in Region 8 on
an as needed basis, when the transport and treatment is appropriate; and
WHEREAS, the Centers for Medicare and Medicaid Services ("CMS"} approved section
438.6 directed payments based on the establishment of a uniform increase to be paid to qualifying
Government Owned EMS Providers for the provision of emergency medical services to Medicaid
eligible persons enrolled in managed care organizations pursuant to the Waiver, which includes
the Medicaid MCO.
NOW THEREFORE, Government Owned EMS Provider and the Medicaid MCO
do hereby agree to the following:
1. Government Owned EMS Provider agrees to make emergency medical services available
to MCO's Medicaid enrollees on an as needed basis, when the transport and treatment is
appropriate.
2. Medicaid MCC) shall receive per member per month section 438.E directed payments for
care and treatment provided by the Government Owned EMS Provider, which the Medicaid
MCC} shall timely remit to the Government Owned EMS Provider in accordance with
AHCA's contractual requirements.
3. Contact information for the parties is as follows:
Name: Tabatha Butcher
Title: Chief EMS
Phone: 239-252-378�
Name: Carol Andrews
Title: Contract Manager
Phone: (813) 394-6750
Tabatha.Butcher Lcoiliercountyfl.gov Carol,Andrews�Molinahealthcare.com
4. The Parties agree any modification to the LOA shall be in the same form, namely the
exchange of signed copies of a revised LOA.
5. This LOA covers the period %J October 1, 2019 through June 3U, 2024 unless terminated
sooner by the termination of section 438.6 directed payments.
IN WITNESS WHEREOF, the Parties have duly executed this LOA on the day and year above
first written. Each party represents that; (1) it has the authority to enter into this Agreement; and
(ii) that the individual signing this Agreement on its behalf is authorized to do so.
GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER
Burt L. Saunders, Chairman
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
7/ I �/2020
DATE
MEDICAID MANAGED CARE ORGANIZATION
Gregory Lipson, VP Network Management -
NAME & TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
DATE
ATTEST
CRYSTAL K. KINZEL, CLERI{
gY:
Alrprovcd as to farm and Icgality
�C7
em;
Assistant County Attorney �e �-
U
Public Emergency Medical Transportation UnHui •m Incx•ease Agreement
This Public Emergency Medical TLansportation Uniform Increase Agreement ("PEMTUTA") is
made and entered into on the 1st day of May, 2020 by and between Collier County
EMS(Government Owned Emergency Medical Service (EMS) Provider) and Humana Medical
Plan, Inc. (Medicaid Managed Care Organization (MCO)) (herein referred to collectively as
"Parties").
WHEREAS, the Medicaid MCO has been awat•ded a contract by the Agency for Health
Care Administration (AHCA) to deliver managed care services to Medicaid enrollees under an
115 Managed Medical Assistance Waiver (the "Waiver") in Region 8, which includes
Cliarlotte, Collier, Desoto, Glades, Hendi4y, Lee and Sarasota County where Government
Owned EMS Provider is located and/or operates;
WHEREAS, AHCA has approved the Government Owned EMS Provider as a qualifying
entity and provides out of network emergency medical services to MCO enrollees in Region 8 on
an as needed basis, when the transport and treatment is appropriate, and
WHEREAS, the Centers for Medicare and Medicaid Services ("CMS") approved section
438.6 directed payments based on the establishment of a uniformincrease to be paid to
qualifying Government Owned EMS Providers for the provision of emergency medical services
to Medicaid eligible persons enrolled in managed care organizations pursuant to the Waiver,
which includes the Medicaid MCO.
NOW THEREFORE, Govertultent Owned EMS Provider and the Medicaid MCO
do hereby agree to the Following:
1. Government Owned EMS Provider agrees to make emergency medical services available
to MCO's Medicaid enrollees on an as needed basis, when the transport and treatment is
appropriate.
2. Medicaid MCO shall receive per member per month section 438.E directed payments for
care and treatment p►•ovided by the Government Owned EMS P►•ovidet•, which the Medicaid
MCO shall timely remit to the Government Owned EMS Provider in accordance with
AHCA's contractual requirements.
3. Contact information for the patties is as follows;
Natne: Tabatha Butcher
Title: Chief EMS
Name: Ann ,iamke
Title: Director Provider Contracting
Phone: 239-252-3780
Phone: (904) 3164899
Email:
Tabatha.Butcher@CollierCountyFL.gov Email ajatiike@humana.com
4. The Parties agree any modification to the Public Emergency Medical Transportation Uniform
increase agreement shall be in the same form, namely the exchange of signed copies of a
revised Public Emergency Medical Transportation Uniform Increase Agreement.
5. This Public Emergency Medical Transportation Uniform Increase Agrge►nent covers the pet'iod
of October 1, 2019 through June 30, 2024 unless terminated sooner by the termination of
section 438.6 directed payments.
IN WITNESS WHEREOF, the Parties have duly executed tllis Public Emergency Medical
T►•ansportation Uniform Increase Agreement on the day and year above first written. Each party
►epresents that; (i) it has the authority to enter into this Agreement; and (ii) that the individual
signing this Agreement on its behalf is authorized to do so.
GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER
Burt L. Saunders, Chairman
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
7/ 14/2020
DATE
MEDICAID MANAGED CARE ORGANIZATION
Ann Jamlce, Directot• Provider Contracting
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE CYF AUTHORIZED INDIVIDUAL
05/12/2020
DATE
ATTEST
CRYSTAL K. KINZEL, CL1rRIC
I3Y:
Apl�ravcd As to form anal legality ,��
Assistant County Attorney C
Letter• of Agreement
This Letter of Agreement ("LOA") is made and entered into on the 1st day of May, 2020 by and
between Collier County EMS (Government Owned Emergency Medical Service (EMS)
Provider) and Floi•ida Community Care, LLC (Medicaid Managed Care Organization (MCO)
(herein referred to collectively as "Parties").
WHEREAS, the Medicaid MCO has been awarded a contract by the Agency for Health
.are Administration (AHCA) to deliver managed care services to Medicaid enrollees under an
1 115 Managed Medical Assistance Waiver (the "Waiver") in Region 8, which includes
Charlotte, Collier, Desoto, Glades, Hendry, Lee and Sarasota County where Government
Owned EMS Provider is located and/or operates;
WHEREAS, AHCA has approved the Government Owned EMS Provider as a qualifying
entity and provides out of network emergency medical services to MCO enrollees in Region 8 on
an as needed basis, when the transport and treatment is appropriate; and
WHEREAS, the Centers for Medicare and Medicaid Services ("CMS") approved section
�38.6 directed payments based on the establishment of a uniform increase to be paid to
qualifying Government Owned EMS Providers for the provision of emergency medical services
to Medicaid eligible persons enrolled in managed care organizations pursuant to the Waiver,
which includes the Medicaid MCO.
NOW THEREFORE, Government Owned EMS Provider and the Medicaid MCO
do hereby agree to the following:
1. Government Owned EMS Provider agrees to make emergency medical services available
to MCO's Medicaid enrollees on an as needed basis when the transport and treatment is
appropriate.
2. Medicaid MCO shall receive per member per month section 438.6 directed payments for
care and treatment provided by the Government Owned EMS Provider, which the Medicaid
MCO shall timely remit to the Government Owned EMS Provider in accordance with
AHCA's contractual requirements.
3. Contact information for the parties is as follows:
Name: Eric Tatum Name:
Title: Director of Provider Services Title:
Phone:
786� 778-6825
Phone:
C-mail: etatum�fcchealthplan.com E-►nail:
Page r oF2
`Tabatha Butcher
Chief EMS
239-252-3780
tabatha.butcherAcol liercountyfl.gov
The Parties agree any modification to the LOA shall be in the same form, namely the exchange
of signed copies of a revised LOA.
4. This LOA covers the period of October 1, 2019 through June 30, 2024 unless terminated
sooner by the termination of section 438.6 directed payments.
IN WITNESS WHEREOF, the Parties leave dilly executed this LOA Qn the day and year above
first written. Each party represents that: (1) it has the authority to enter into this Agreement, and
(ii) that the individual signing this Agreement on its behalf is authorized to do so.
GOVERNMENT OWNED EMERGENCY MEDICAL SERVICES PROVIDER
Bllrt L. Saunders, Chairman
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AtTHORIZED INDIVIDUAL
7/ 14/2020
DATE
MEDICAID MANAGED CARE ORGANIZATION
Nestor Plana, Chief Executive Officer
NAME &TITLE OF AUTHORIZED INDIVIDUAL
SIGNATURE OF AUTHORIZED INDIVIDUAL
DATE
ATTEST
CRYSTAL K. KINZEL, CLERK
13Y:
Page 2 of2
Approved as to tbrm anc! legality
Wl
Assistant County Attmney COP
�a
tQ