AGENDA REPORT
DATE: September 28, 2026
TO: City Commission
FROM: Bill McDaniel, City Manager
SUBJECT: Intergovernmental Transfer Program with the State of Florida for Medicaid Managed Care Patients.
EXECUTIVE SUMMARY:
Plant City Fire Rescue (PCFR) transports approximately 4,700 patients annually to local hospital emergency rooms, generating approximately $1,400,000 per year in revenue from Medicare, Medicaid, private commercial insurance companies, and individual payers. The transport services are billed and collected by a private contractor, Digitech. Of the total patients transported to the hospital each year, approximately 12% are covered by Medicaid. The average reimbursement for the services provided to Medicaid patients is lower than payments received from Medicare and private health insurance.
In 2016, the State of Florida authorized the creation of a Certified Public Expenditure (CPE) program to provide supplemental payments to publicly owned and operated emergency medical transportation providers for Medicaid fee-for-service patients transported to local hospitals. This program leverages approximately 60% in federal Medicaid reimbursements by allowing the State to certify the public expenditures incurred by the City as the State share. Since the inception of the CPE program in 2017, the City has received supplemental payments totaling $1,108,639.25 to close the gap between costs incurred and revenue received for Medicaid patient transports.
In 2019, the State Legislature authorized expansion of the program to include the Medicaid Managed Care population. The City has participated in the Medicaid Managed Care program annually since 2020 through an agreement with the Agency for Health Care Administration (AHCA). To leverage the approximately 60% federal share for the State fiscal year 26/27, the City will make an intergovernmental transfer (IGT) of $275,263.21 to the Agency for Health Care Adminstration (AHCA). In return, six Medicaid Managed Care providers within the Tampa Bay region will reimburse the City $617,597.52 for a net gain of $342,334.31.
The City has executed agreements with six Medicaid Managed Care providers: Aetna Better Health of Florida, Inc., Florida Community Care, LLC, Humana Medical Plan, Inc., Simply Healthcare Plans, Inc., Sunshine State Health Plan, Inc., and United Health Care of Florida, Inc. These agreements are in effect through September 30, 2027. The City's continued participation in the Medicaid Managed Care program is contingent upon maintaining an active agreement with AHCA.
Approval of the proposed agreement with AHCA will allow the City to continue its participation in the Medicaid Managed Care program for the upcoming State fiscal year and receive supplemental reimbursement for eligible Medicaid Managed Care patient transports.
RECOMMENDATION:
That the City Commission authorize the City's continued participation in the State of Florida Medicaid Managed Care supplemental payment program, authorize an intergovernmental transfer (IGT) to the Agency for Health Care Administration (AHCA) in the amount of $275,263.21, and authorize the City Manager to execute the required agreement with AHCA and any related documents necessary for participation in the program.
FISCAL IMPACT:
The payment to the AHCA is included in the proposed FY26/27 budget. Funds from the Medicaid Managed Care providers will be deposited in the General Fund, Org # 00132705, Obj # 331262 - IGT Medicaid Managed Care Grant.
Prepared by: David Dittman, Fire Chief