HomeMy WebLinkAboutR-02-0854J-02-690
7/24/02
RESOLUTION NO. 02— 854
A RESOLUTION OF THE MIAMI CITY COMMISSION
AUTHORIZING THE DIRECTOR OF FINANCE TO
REIMBURSE THE STATE OF FLORIDA, ACTING
THROUGH THE ATTORNEY GENERAL AND ON BEHALF OF
THE AGENCY FOR- HEALTH CARE ADMINISTRATION,
THE SUM OF $474,168.46, IN FULL AND COMPLETE
SETTLEMENT OF ANY AND ALL CLAIMS AND DEMANDS
AGAINST THE CITY OF MIAMI, FOR REIMBURSEMENT
OF MEDICAID PAYMENTS MADE TO THE CITY OF
MIAMI FOR AMBULANCE SERVICE PROVIDED TO
MEDICAID PATIENTS, UPON THE EXECUTION OF A
SETTLEMENT AGREEMENT RELEASING THE CITY OF
MIAMI, ITS PRESENT AND FORMER OFFICERS,
AGENTS AND EMPLOYEES FROM ANY AND ALL CLAIMS
AND DEMANDS; ALLOCATING FUNDS FROM THE
GENERAL FUND, ACCOUNT CODE
NO. 001000.000000.2223; FURTHER AUTHORIZING
THE CITY ATTORNEY TO TAKE ALL REASONABLE AND
NECESSARY ACTIONS, INCLUDING FILING SUIT, TO
OBTAIN RECOURSE FROM ANY THIRD PARTIES
DETERMINED TO BE LIABLE.
BE IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI,
FLORIDA:
Section 1. The Director of Finance is authorized to
reimburse the State of Florida, acting through the Attorney
General and on behalf of the Agency for Health Care
Administration, the sum of $474,168.46, in full and complete
settlement of any and all claims and demands against the City of
Miami, for reimbursement of Medicaid payments made to the City of
CITY C0NWSSION
wETING
J U E_ 2 5 2002
Resolution No.
02- 854
Miami for ambulance service provided to Medicaid patients, upon
the execution of a settlement agreement releasing the City of
Miami, its present and former officers, agents and employees from
any and all claims and demands, with funds allocated from the
General Fund, Account Code No. 001000.000000.2223.
Section 2. The City Attorney is authorized to take all
reasonable and necessary actions, including filing suit, to
obtain recourse from any third parties determined to be liable.
Section 3. This Resolution shall become effective
immediately upon its adoption and signature of the Mayor.'/
PASSED AND ADOPTED this 25th day of July 2002.
4 � �X_ Z� /X�o
MANUEL A. DT_W, MAYOR
ATTEST:
PRIS ILLA A. THOMPSON, CITY CLERK
APPROVF.. �A O FOR CORRECTNESS
6 VILAT�ELLO
ORNEY
447:tr:LB:BSS:JHV
1� If the Mayor does not sign this Resolution, it shall become
effective at the end of ten calendar days from the date it was
passed and adopted. If the Mayor vetoes this Resolution, it shall
become effective immediately upon override of the veto by the
City Commission.
Page 2 of 2 02— g J 4
CITY OF MIAMI
CITY ATTORNEY'S OFFICE
MEMORANDUM
TO: Mayor and Members of
FROM: Alejandro Vilarello,
DATE: July 18, 2002
CA -20
RE: Proposed Res@Wio r City Commission Meeting — July 25, 2002
Settlement involy g Medicaid overpayment (J-02-690)
This matter arises out of an audit of Medicaid payments made to the City as
reimbursement for ambulance service provided to Medicaid participants. The State of Florida
acting through the Office of the Attorney General and on behalf of the Agency for Health Care
Administration, conducted an audit of Medicaid payments made to the City for ambulance
service during the period April 1, 1995 through October 31, 2000. The Office of the Attorney
General calculated $1,425,640.44 in overpayments, claiming that certain ambulance runs and
concomitant services, which were billed as advanced life support, should have been classified as
basic life support or not provided.
The City contested the State's statistical methods, the criteria used for determining
appropriate levels of service, the classification of services within levels, and the State's failure to
provide credit for previous reversing entries. The State acknowledged errors in each of these
categories and has agreed to payment of a revised figure of $474,168.46, and to waive all
penalties, fees and interest. The proposed settlement will be paid from a sum set aside for
Medicaid reimbursements. Chief Bryson concurs in the settlement.
To minimize future reimbursements the City has implemented the following strategies:
1) During the audit period the City used two providers for Medicaid billing
services. The City has discontinued use of the provider with the
statistically higher error rate;
2) Fire Rescue has enhanced staff training in the Medicaid billing
guidelines;
3) Fire Rescue has accelerated implementation of computerized tracking
and storage of records relating to Medicaid eligible services; and
4) The City has provided input and is monitoring proposed state legislation
which attempts to clarify and streamline Medicaid reimbursement
procedures.
The attached proposed Resolution seeks authorization for the settlement of all claims
against the City of Miami in the above referenced matter for the amount of $474,168.46. The
City Attorney's Office and the Fire Rescue Department have investigated and evaluated the
E:\BSolomon\MemosL.ettersCharts\W743.doc
02- 854
Memorandum
Page 2
July 18, 2002
matter and approved the recommendation of this settlement. Funds in the amount of
$474,168.46 will be allocated from the General Fund, Account Code No. 001000.000000.2223.
W743:JHV
cc: Carlos A. Gimenez, City Manager
Pricilla A. Thompson, City Clerk
Elvi Alonso, Agenda Coordinator