Agenda 11/15/2016 Item #16E 6 16E.6
11/15/2016
EXECUTIVE SUMMARY
Recommendation to approve an Amendment to Agreement 12-5874 for EMS Billing to add
consulting services for the purpose of enrollment in the Florida EMS Public Emergency Medical
Transports Medicaid program.
OBJECTIVE: To increase revenue by enrollment in the Florida EMS Public Emergency Medical
Transports(PEMT)Medicaid program.
CONSIDERATIONS: On November 13, 2012 the Board approved the selection of Advanced Data
Processing, a subsidiary of Intermedix Corporation, to provide EMS billing services. Approval of this
Amendment will allow Intermedix to provide consulting services to the County to enroll in the Florida
EMS PEMT Medicaid program and allow for the further recoupment of previously unreimbursed
services.
Currently, Medicaid payment rates for ambulance services do not recognize the actual cost of providing
those services. Reimbursement is much less than the actual cost to EMS providers. The Florida Agency
for Health Care Administration (AHCA) plans call for a Certified Public Expenditure Program for
Medicaid fee-for-service claims providing additional federal funding to EMS providers that serve
Medicaid-eligible recipients.
Participation in the PEMT CPE will require submission of an annual cost report to AHCA,due November
30th of each year. The consulting service will assist in the cost reporting and provide audit support.
FISCAL IMPACT: These services will be provided on a 15% contingency basis to be paid on
successful recovery of incremental Medicaid revenues. Projected first year revenue is approximately
$198,000 less a service fee of$29,700 for a net revenue of$168,300.
LEGAL CONSIDERATIONS: This item is approved as to form and legality, and requires majority
vote for Board approval.-SRT
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting from this
action.
RECOMMENDATION: That the Board of County Commissioners approves an Amendment to
Agreement 12-5874 for EMS Billing to add consulting services for the purpose of enrollment in the
Florida EMS Public Emergency Medical Transports Medicaid program.
Prepared By: Artie Bay, Supervisor, Emergency Medical Services Admin.
ATTACHMENT(S)
1. Amendment No.2 to Agreement 12-5874 (PDF)
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16.E.6
11/15/2016
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.6
Item Summary: Recommendation to approve an Amendment to Agreement 12-5874 for EMS
Billing to add consulting services for the purpose of enrollment in the Florida EMS Public Emergency
Medical Transports Medicaid program.
Meeting Date: 11/15/2016
Prepared by:
Title: Supervisor-Accounting—Administrative Services Department
Name: Artie Bay
10/25/2016 3:45 PM
Submitted by:
Title: Department Head-Administrative Svc—Administrative Services Department
Name: Len Price
10/25/2016 3:45 PM
Approved By:
Review:
Administrative Services Department Pat Pochopin Level 1 Division Reviewer Completed 10/25/2016 3:48 PM
Emergency Medical Services Tabatha Butcher Additional Reviewer Completed 10/26/2016 5:00 PM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 11/01/2016 2:16 PM
County Attorney's Office Scott Teach Level 2 Attorney Review Completed 11/02/2016 9:44 AM
County Attorney's Office Jeffrey A.Klatzkow Level 3 County Attorneys Office Review Completed 11/02/2016 10:56 AM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 11/02/2016 11:35 AM
Office of Management and Budget Laura Wells Additional Reviewer Completed 11/02/2016 1:32 PM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 11/06/2016 5:51 PM
Board of County Commissioners MaryJo Brock Meeting Pending 11/15/2016 9:00 AM
Packet Pg. 1311
16.E.6.a
AMENDMENT No.2 TO AGREEMENT 12-5874
FOR EMS BILLING
THIS AMENDMENT No. 2 (the "Amendment") is made and entered into this 8th day of November, 2016 (the
"Effective Date") by and between Collier County, Florida, a political subdivision of the State of Florida ("County") and
Advanced Data Processing,Inc.,a subsidiary of Intermedix Corporation,a Delaware corporation("Contractor"). c
WHEREAS, County and Contractor entered into an Agreement for EMS Billing, effective November 13, 2012 -°
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(the"Agreement")as amended;and w
WHEREAS, County has requested and Contractor agrees to provide consulting services to County to enroll in the :6-
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Florida EMS PEMT (Public Emergency Medical Transports) Medicaid program, and provide ongoing consulting/costing ti
services for both the Florida CPE (Certified Public Expenditures) PEMT and the proposed IGT (Intergovernmental co
Transfer) PEMT, which includes Medicaid managed care transports revenue programs (the "Consulting Services") for a N
period running coterminous with that currently provided in the Agreement. w
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NOW THEREFORE, County and Contractor agree to amend the Agreement to include the following: aEi
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1. New Schedule A-1 (Description of Consulting Services and Revenue Recognition Process Related to the E
EMS PEMT Medicaid Program,the Florida CPE PEMT Program and the IGT PEMT Program)and new Schedule A-2 0
(CPE Program for EMS and Medicaid Managed Care Supplemental Payment Program Service Fees)attached herewith are c
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hereby added to the Agreement. E
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1. Capitalized terms not otherwise defined in this Amendment shall have the meanings ascribed to such terms in the E
Agreement. All other terms and conditions of the Agreement are hereby ratified and shall remain in full force and effect Q
except to the extent this Amendment expressly modifies or is inconsistent with the terms and conditions of the Agreement, cca
in which case the terms of this Amendment shall be controlling. o
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IN WITNESS OF,the parties have executed this Amendment to the above-referenced Agreement effective as of 0
the Effective Date. Q
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ATTEST: County:Board of County Commissioners,Collier County,Florida
Dwight E.Brock,Clerk of Courts I,-
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By: By:
Date: Donna Fiala,Chair
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Approved as to form and legality: m
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Deputy County Attorney
Contractor:Advanced Data Processing,Inc., N
a Subsidiary of Intermedix Corporation,a Delaware z
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BY: �dfi _ _yi✓ri-' 13
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First Witness ' a>
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AMENDMENT TO AGREEMENT 12-5874 \'.1''
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I6.E.6.a
Schedule A-1
Description of Consulting Services and Revenue Recognition Process Related to the
EMS PEMT Medicaid Program,the Florida CPE PEMT Program and the IGT PEMT Program
• Term of Consulting Services:To run conterminous with the period currently provided in the Agreement. a)
• Drafting application materials and responding to requests for additional information necessary for the provider to
gain approval to participate in the Ambulance Supplemental Payment Programs. 15—
• Preparing a fiscal impact study and presenting results to department/state stakeholders to demonstrate benefits of a E
Continuing Public Expenditure("CPE")Program,Medicaid Managed Care supplemental payment,and uninsured w
CPE(if applicable)program to the provider.
• Identifying eligible costs and developing appropriate cost allocation methodologies to report only allowable costs is-
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for providing emergency medical services to Medicaid and,as applicable,uninsured populations. N
• Preparing the annual Medicaid cost report for EMS on behalf of provider.
• Conducting analysis of the provider's financial and billing data in order to prepare and submit annual cost reports, aa)
the mechanism for providers to receive additional revenue under Ambulance Supplemental Payment Programs. y
• Providing comprehensive desk review support, including but not limited to conducting reviews of all cost a)
settlement files, performing detailed analysis of billing reports generated by Medicaid agencies to ensure that all Q
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allowable charges and payments are encompassed in the calculation of the final settlement, and drafting letters
and providing supporting documentation to meet Medicaid requirements and expedite settlement. cci
• Performing relevant analysis to determine a viable Medicaid managed care supplemental payment methodology. -a
• Executing Medicaid managed care supplemental payment calculations in adherence with the approved a)
methodology. ,Q
• Determining enhanced supplemental payments realized by provider,as necessary. cw
• Conducting comparative analysis to identify significant trends in billing and financial data. >
• Providing charge master review to ensure that the provider is optimizing charges to drive revenue generation. o
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• Meeting with the Florida Agency for Health Care Administration (AHCA) and Client to further develop the Q
supplemental payments program for both Medicaid managed care and uninsured patient transports. c
• Respond to, and represent Client on any AHCA or CMS audit, review or communication regarding any PEMT N
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cost report prepared by Intermedix and delivered to AHCA on behalf of the Client.
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AMENDMENT TO AGREEMENT 12-5874
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16.E.6.a
Schedule A-2
CPE PROGRAM FOR EMS AND MEDICAID MANAGED
CARE SUPPLEMENTAL PAYMENT PROGRAM SERVICE FEES
All revenue realized by the Client from the Certified Public Expenditure (CPE)Program for Emergency Medical Services 11"—
and Medicaid Managed Care Supplemental Payment Program shall be paid in full directly to Client. Revenue realized as a
result of the Certified Public Expenditures (CPE) for Emergency Medical Services (EMS) shall be determined by the w
Medicaid cost settlement determined through the Medicaid cost report.
Intermedix will not receive any compensation until the CPE for Emergency Medical Services settlement or Medicaid r`t..
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Managed Care Supplemental Payment revenues are received by the Client. Intermedix will invoice and receive revenue
upon the receipt of revenue received by Client for either initiative, meaning revenue does not have to be generated for both Csi
the CPE for Emergency Medical Services and the Medicaid Managed Care Supplemental Payment program,rather revenue
simply needs to be generated for either initiative to allow Intermedix to generate invoices. Intermedix will invoice Client
based on the final CPE for Emergency Medical Services settlement or Medicaid Managed Care Supplemental paymentsCD
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within thirty(30)days of receipt of funds by the Client.
The contingency fee to be paid associated with the respective successful implementation, generation and recovery of $
incremental Medicaid revenues as a result of the CPE for Emergency Medical Services and Medicaid Managed Care
Supplemental Payment programs is established as fifteen percent(15%) of Client revenues collected from the State under
those programs. Client will remit payment to Intermedix upon receipt of a proper invoice and in compliance with Chapter c
218 Fla. Stats.,otherwise known as the"Local Government Prompt Payment Act." E
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AMENDMENT TO AGREEMENT 12-5874
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