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Ratification of Public Emergency Medical Transportation Letter of Agreement on Behalf of Hernando County Fire and Emergency Services Department With State of Florida, Agency for Health Care Administration for FY 2026-27
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BRIEF OVERVIEW
The State of Florida Agency for Health Care Administration (AHCA) created a supplemental program for Medicaid managed care patients who are transported to the hospital by public emergency medical transportation (PEMT) providers and has appropriated funds for this program through intergovernmental transfers (IGT’s).
Medicaid pays a minimal amount for transport service, and the County has participated in this service for 5 years. By participating in this program, Hernando County Fire and Emergency Services has received additional revenue which has helped offset the rising cost of medical care.
This plan requires a letter of agreement (LOA) not only with AHCA but also with each of the Managed Care Organizations (MCO). The Board of County Commissioners had previously granted the County Administrator the authorization to sign the letters of agreement for each of the five (5) MCOs. The agreements from the MCOs typically come in at different times throughout October and November for signature. The Agency is currently experiencing delays that impact the ability to finalize the payment model.
Due to time restraints on the lateness of receiving the Letter of Agreement (LOA) on September 14th and the need to submit to AHCA by October 1, 2026, attached for ratification is the LOA that was executed by the County Administrator on September 14, 2026. Once the payment model is finalized and accurate payment amounts have been determined, the Agency will issue amended LOA’s reflecting the updated figures.
STRATEGIC PLAN INITIATIVES
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FINANCIAL IMPACT
Hernando County Fire and Emergency Services (HCFR) benefits from receiving net revenues of approximately $2,000,000 a year for participating in this program. This revenue is currently budgeted in FY 27.
Revenue:
Fund: HC Fire Rescue-Rescue Fund - B111; Department: HCFR-Rescue - 141; Account: SRV Chg-Ambulance Medicaid - 342603.
LEGAL NOTE
The Board is authorized to act on this matter pursuant to Chapter 125, Florida Statutes.
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RECOMMENDATION
It is recommended that the Board ratify approval of the attached Public Emergency Medical Transportation Letter of Agreement that was signed by the County Administrator on September 14, 2026.