2nd Amendment 05/19/2004
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE:
July 15, 2004
TO:
Sheila Barker, Director
Administrative Services
FROM:
Maria Z. Fernandez
Group Insurance Administrator
Pamela G. Hanc~
Deputy Clerk
ATTN:
At the May 19, 2004, Board of County Commissioner's meeting the Board granted
approval and authorized execution of the following:
Amendment to the Employee Assistance Program Agreement between Monroe County
and Mental Health Care Center of the Lower Keys, Inc. d/b/a Care Center for Mental Health for
the Florida Keys Mosquito Control District, a covered entity under the Monroe County Employee
Assistance Program, who will no longer be covered effective May 1, 2004.
Amendment to Administrative Services Agreement between Monroe County and Acordia
National for monthly claim administration fees for the Florida Keys Mosquito Control District
(FKMCD). This amendment is required effective May 1,2004 as the FKMCD will no longer be a
covered entity under the Monroe County Employee Benefit Plan therefore eliminating the need
for administrative fees, except for the handling of run-out claims.
/Organ Transplant Network Amendment between Monroe County and MultiPlan, Inc.
With the use of global contract rates, savings can range between 30-50% across the spectrum of
the eight transplant categories. MultiPlan has credentials the facilities in the network and their
outcomes meet or exceed national averages.
Enclosed is a duplicate original of each of the above-mentioned for your handling. Should
you have any questions please do not hesitate to contact this office.
cc: County Administrator w/o documents
County Attorney
Finance
File /'
MULTIPLAN, INC.
ORGAN TRANSPLANT NETWORK AMENDMENT
THIS AMENDMENT, effective upon signature by Client, is by and between MultiPlan, Inc.,
115 Fifth Avenue, New York, New York 10003-1004 ("MultiPlan") and Monroe County
Board of County Commissioners, located at 1100 Simonton Street, Key West, FL 33040,
("Client").
WHEREAS, the above-named parties entered into a contract, effective January 1, 2003, under
which MultiPlan agreed to give Client's Participants access to MultiPlan's Facility Network at
MultiPlan's negotiated rates ("the Agreement"); and
WHEREAS, MultiPlan has established an Organ Transplant Network composed of Facilities
that have agreed to accept a global rate as full reimbursement for organ transplant services
provided to Participants of MultiPlan Client that have purchased access MultiPlan's Organ
Transplant Network, and;
WHEREAS, Client desires to access MultiPlan's Organ Transplant Network in the MultiPlan
Program; and
THEREFORE, the parties hereby agree to amend the Agreement by adding the following:
A. DEFINITIONS The following definitions shall apply for the purposes of this
Amendment:
1. Access Fees The rates payable by Client to MPI for access to MPI's Organ Transplant
Network, as set forth in paragraph B(7), herein.
2. Benefit Plan A contract, policy, or other document, under which a Client is obligated to
provide benefits on behalf of a Participant for transplant services in an amount that meets or exceeds
the Contract Rates applicable hereunder.
3. Clean Claim A completed UBF92, or other standard billing form providing the same
information.
4. Contract Rates The global rates of reimbursement ("Global Contract Rates"), and other rates
of reimbursement for organ transplant and transplant-related health care services rendered to
Participants as set forth in MPI's agreement with an MPI Provider.
5. Employee "Employee" includes retirees eligible for coverage under Client's Benefit
Program. In the event the Client is a union, all references to "Employee" in this Agreement and its
attachments shall be construed to refer to the union member.
6. Market A geographic region defined by MPI for pricing purposes.
7. Savings The difference between the applicable Contract Rate and the MPI Provider's billed
charges (excluding surcharges and the cost of personal convenience items).
B. RIGHTS AND OBLIGATIONS OF CLIENT
1. Cooperation with Transplant Coordinator Client shall work cooperatively with
MultiPlan's Organ Transplant Program Coordinator, Case Managers, and other personnel, and
shall comply with the procedures established by MultiPlan for access to the Organ Transplant
Network.
2. Participant Enrollment The Client or the Client's Case Manager shall call MultiPlan's
Transplant Referral telephone number, 800-239-2745 to initiate the Participant's access to the
Organ Transplant Network. Client shall not be entitled to access to the Organ Transplant
Program Contract Rates secured by this Agreement unless the Participant is enrolled by
MultiPlan in the Organ Transplant Program for each proposed transplant before the transplant is
performed.
3. Eligibility Determinations and Verification of Benefits Client shall be soley responsible for
making all determinations regarding eligibility and compensability of benefits in connection with
this Agreement. Upon receipt of a request from MultiPlan for verification of a Participant's
eligibility under MultiPlan's Organ Transplant Program, Client shall forward proof of eligibility
and the Participant's program benefits limits to MultiPlan, using the Notification and Benefit
Certification form to be provided by MultiPlan. MultiPlan shall transmit this proof to the
Provider.
4. Claim Repricing Hospital and/or Client shall forward to MultiPlan all clean claims
received for services rendered under the Organ Transplant Program to MultiPlan for repricing.
MultiPlan shall return to Client, by mail or facsimile transmission, instructions relating to
payment of the claim.
5. Claim Payment Client shall pay all claims for services rendered by providers in
MultiPlan's Organ Transplant Network within thirty business days of receipt of the Clean Claim.
6. Explanations of Benefits Client shall indicate clearly on each Explanation of Benefits
issued regarding transplant services that Client is accessing MultiPlan's Transplant Network.
7. Network Access Fee Amounts
2
a. Client shall pay MultiPlan Network Access Fee(s) as set forth in the Flat Rate
Access Fee Schedule below:
Heart
$10,000.
Lung
$10,000.
Kidney
$ 3,500.
Pancreas
$ 3,500
Liver
$20,000.
Bone Marrow Transplants
Autologous and PBSC
Allogeneic- Matched Related Donor
Matched Unrelated Donor
$ 5,000.
$ 10,000.
$ 20,000.
b. During the pre-transplant phase, MultiPlan shall invoice Client for an Initial Network
Payment of one thousand dollars ($1,000.00), which shall be paid by Client within ten (10)
days of the date of the invoice, Following the transplant phase, MultiPlan shall invoice
Client for the remaining balance of the total Flat Rate Access Fee, which amount shall be
paid by Client within ten (10 ) days of the date of the invoice. In the event that the
Participant receives pre-transplant services but does not undergo transplant surgery, Client
shall pay MPI for transplant-related services rendered to said Participant the Initial Network
Payment of$l,OOO.OO, plus
if Client pays percentage of Savings Access Fees under the Agreement to which
this Amendment is annexed, Client shall pay Network Access Fees at the
percentage rate set forth in the Agreement, or
if Client pays capitated Access Fees under the Agreement to which this Amendment
is annexed, Client shall pay Network Access Fees of twenty-two percent (22%).
8. Electronic Format Client agrees to use its best efforts to accept electronic invoicing from
MPI, on diskette, and to submit payment information to MPI in the same format. Client agrees
that the appropriate information systems and/or accounting personnel shall be available to review
and implement necessary electronic systems. Client also agrees to explore the feasibility of
electronic data interchange as a means of transmitting both claims and financial information.
9. Transplant Services Included in Global Contract Rates The Global Contract Rates
negotiated by MultiPlan include, to the extent that they are medically necessary: general nursing
care; room and board and all ancillary services; use of intensive or special care facilities; x-ray
examination (other than dental x-rays); use of operating room and related facilities;
encephalography; drugs, medications, and biologicals; laboratory testing and services; all
cardiovascular testing; special tests, when medically necessary; nuclear medicine; physical and
rehabilitation therapy; oxygen and oxygen therapy; anesthesia and anesthesia services;
intravenous injections and solutions; surgical and medical services provided by Provider; pre-
operative care; post-operative care; special duty nursing; short procedure unit services;
3
Monroe County Board of County Commissioner
1100 Simonton Street
Key West, FL 33040
BY~ (~ 05/19/2004
SIgnature Date
Murray E. Nelson. MaYorffhairm~
Print Name and Title ~ ~ -:::..
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secondary care, including private accommodations in a regular medical/surgical bed not
requiring placement in an intensive care unit or other unusually high level of medical and
nursing care, inclusive of room and board and all ancillary services, but exclusive of personal
comfort and convenience items; and tertiary care, including all items included in secondary care
and, in addition, such items and services as are normally and usually provided by Provider in
conjunction with care of inpatients in its intensive care unit. However, reference must be had to
a specific Provider's MultiPlan Organ Transplant Program contract rates for details regarding the
services included in that Provider's rates.
10. Services Not Included in Contract Rates The Global Rates negotiated by MultiPlan do
not include: personal comfort or personal convenience items; custodial care; or services which
are not necessary to the care or treatment of the illness or illnesses which necessitated the
transplant, as determined by Provider's Chief of the Medical Staff, except as incidental to the
transplant.
11. Dispute Resolution In the event of a dispute between Client and an MPI Provider
regarding a claim or payment for covered services under this Agreement, Client shall notify
MPI, in writing, of the dispute within sixty days of receipt of the Clean Claim. Upon request and
at no charge, Client shall provide information reasonably necessary for MPI to facilitate
resolution of any disputes that arise between Client and an MPI Provider, such as a copy of its
benefits and/or utilization programs, and such utilization and/or claims data as MPI may
reasonably request. MPI will make its best efforts to assist Client in resolving the dispute with
the MPI Provider. If the Client fails to notify MPI of a dispute consistent with this provision,
Client may not otherwise dispute the claim(s) at issue.
IN WITNESS WHEREOF, the undersigned, duly authorized representatives of the parties,
have executed this Amendment.
MUL TIPLAN, INC.
115 Fifth Avenue
New York, New
By:
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