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RESOLUTION APPROVING EXECUTION OF AN AGREEMENT WITH THE STATE OF FLORIDA TO REMIT $497,686 FOR MEDICAID-FUNDED HEALTH SERVICES PROVIDED BY MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. UNDER COUNTY CONTRACT RFP429A AND APPROVING A CONTRACT AMENDMENT WITH MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. TO CREDIT MIAMI-DADE COUNTY $509,142 FOR SERVICES RENDERED

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WHEREAS, this Board desires to accomplish the purposes outlined in the accompanying memorandum, a copy of which is incorporated herein by reference; and

WHEREAS, this Board desires to contribute to the State of Florida to increase reimbursement for the provision of Medicaid funded health sources for the greater good of the community,

NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MIAMI-DADE COUNTY, FLORIDA, that this Board approves the Letter of Agreement with the State of Florida for Medicaid-funded health services and Supplemental Agreement No. 5 to Contract 429a, in substantially the form attached hereto and made a part hereof, and authorizes the County Mayor or County Mayor�s designee to execute same for and on behalf of Miami-Dade County and to exercise any cancellation and renewal provisions and any other rights contained therein.

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Date:

To: Honorable Chairman Joe A. Martinez
and Members, Board of County Commissioners

From: Alina T. Hudak
County Manager

Subject: Resolution Approving a Letter of Agreement with the State of Florida to remit $497,686 for Increased Reimbursement for Medicaid-Funded Health Services Provided by Mount Sinai Medical Center of Florida, Inc.

STAFF RECOMMENDATION
Recommendation
It is recommended that the Board of County Commissioners (Board) approve the attached resolution approving a Letter of Agreement with the State of Florida to remit $497,686 for increased Medicaid reimbursement for Medicaid-funded health services provided by Mount Sinai Medical Center of Florida, Inc., (Mount Sinai) and approve a contract amendment to Contract No. 429A with Mount Sinai for employee medical assessment testing to credit Miami-Dade County $509,142 for services rendered as of August 2010.

Scope
Mount Sinai is located in Commission District 4. Its service area is countywide.

Fiscal Impact/Funding Source
The fiscal impact of the $497,686 is budget neutral due to the $497,686 being credited to Miami-Dade County (plus an added $11,456 to cover UAP and IG Fees) from the Employee Medical Testing in Contract No. 429A.

Track Record/Monitor
Mount Sinai is a not-for-profit hospital, providing $91 million in charity and uncompensated care last year. It is one of nine statutory teaching hospitals in Florida.

MANAGER'S BACKGROUND
Background
On June 3, 2010 the Board approved R-653-10, a similar agreement for Mount Sinai, but since the terms of that agreement were for a singular payment, this request must come back to the Board for approval.

Through the State's Medicaid "buyback" program, contributions from local governments result in a higher Medicaid reimbursement rate for public hospitals, teaching hospitals, and those hospitals serving a disproportionately large Medicaid population. Currently, the County also participates in the �buyback program� through Jackson Memorial Hospital (JMH). This agreement will not affect JMH�s reimbursement.

If approved, the County can use a $509,142 credit from employee medical assessment testing fees due to Mount Sinai to remit $497,686 of these funds, on behalf of Mount Sinai, to the Medicaid "buy back" program. The $497,686 would then be eligible, through an Intergovernmental Transfer (IGT) payment, for federal matching dollars as coordinated through the State of Florida Agency for Health Care Administration. This remittance by the

County, on behalf of Mount Sinai, for the State's Medicaid "buyback" program is only made possible through our current contractual relationship and therefore the County will have no additional liability to Mount Sinai beyond this singular payment.

The Board approved Contract No. 429A with Mount Sinai for employee medical assessment testing on December 2, 2004. Under the contract, Mount Sinai performs employment physical examinations for County employees and applicants. This contract expired in December 2010 but services have continued under supplemental agreements.