12/08/1999 AgreementBRANCH OFFICE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050
TEL. (305) 289-6027
FAX (305) 289-1745
MEMORANDUM
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Mannp I. Rotbage
CLERK OF THE CIRCUIT COURT
MONROE COUNTY
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
FAX (305) 295-3660
DATE: January 3, 2000
TO: Sheila Barker, Director
Human Resources
ATTN: Nancy Cohen, Administrator
Workers Compensation
FROM: Pamela G. Hancock
Deputy Clerk
BRANCH OFFICE
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
FAX (305) 852-7146
At the December 8, 1999, Board of County Commissioner's Meeting the Board granted
approval and authorized execution of a Letter of Understanding regarding the Monroe County
Board of County Commissioners Managed Care Arrangement.
Enclosed is a duplicate original for your handling.
do not hesitate to contact this office.
Cc: County Administrator w/o document
County Attorney
Finance
File
Should you have any questions please
Letter of Understanding Regarding the
Monroe County Board of County Commissioners
Managed Care Arrangement
This Letter of Understanding outlines the responsibilities of each parties involved in providing the
Workers' Compensation Managed Care Arrangement for Florida Employees. The overview of the MCA
program as outlined in Section I of our MCA application, describes in detail the program overview.
As the payor, Monroe County Board of County Commissioners has read and understands the enclosed
application to the Agency for Health Care Administration for providing a Managed Care Arrangement for
its employees under Section 440.134, Florida Statutes.
Occupational Health Systems will provide the Case Management including Return to Work Coordination,
Medical Bill Review and Utilization Management programs as outlined in the MCA application. They will
manage the grievance process in conjunction with the contracted network provider, Choice Managed
Networks.
Choice Managed Networks is responsible for the provider network, which includes but is not limited to
contracting and verifying of credentials of duly licensed network providers according to the Choice
Managed Network's Policy and Procedures, and the rules and regulation that support Section 440.134,
Florida Statutes. Choice Managed Networks will also maintain a provider Quality Assurance program and
a grievance procedure, similar to the Utilization Review Accreditation Commission (URAC) workers'
compensation appeals procedure.
ISAC is responsible for claims administration. Occupational Health Systems will monitor the services of
Choice Managed Networks on behalf of Monroe County Board of County Commissioners to ensure
compliance with Section 440.134, Florida Statutes.
It is the business relationship between Occupational Health Systems, Monroe County Board of County
Commissioners and Choice Managed Networks that construe the Managed Care Arrangement for Florida
Workers' Compensation. Under this relationship it is understood and agreed that Occupational Health
Systems and Choice Managed Networks must require approval, in writing from Monroe County Board of
County Commissioners before Occupational Health Systems and Choice Managed Networks can make
substantial changes in or to the provider network.
INDEMNIFICATION: Each party shall indemnify and hold the other and any agent or employees acting
on behalf of each party, harmless from and against any and all claims, losses, liabilities, damages, costs,
penalties, interests and expenses, including reasonable attor ng.'_ : from such party's wr gful or o
negligent actions or omissions regarding obligations under S,rr► otwithstanding tO fo goiRa�
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provision, no party shall be liable to another or responsib:to'pl'ovide de
mnification
whatsoever regarding claims by patients concerning the aGtsrj�i't%` r + of any MCA n Z
provider. r. , NY L. KOLHAGE..�S nit
Signed and Dated:
Date
Mo County Boar if County Commissioners
BY cvN da w
Occupational Health Systems
By: Luis A. Ramos
Cho' Manag *Netwosy: exan ra e
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Date
ate
APPROVED AS F i
AN kL
BY
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