HomeMy WebLinkAboutSubstitute Memo-45,410s+1k., C f 1
CITY OF MIAMI, FLORIDA
INTER -OFFICE MEMORANDUM
TO :
FROM :
Honorable Mayor and Members
of the City Commission i
/
Joe Arriola
Chief Administrator/City Manager
DATE :
SUBJECT :
REFERENCES:
ENCLOSURES:
February 17, 2004
FILE :
A resolution authorizing the
City Manager to execute a
Professional Services
Agreement with HealthCare
Data Management
RECOMMENDATION
It is respectfully recommended that the City Commission adopt the attached resolution,
authorizing the City Manager to execute a professional services agreement, in a form
acceptable to the City Attorney, with "HCDM", the top ranked firm, for the period of one
year. The funding will be provided from Account Code 514401.623301.6.657.
A one time fee of $20,000 will be paid upon execution of agreement. However, it will
be refunded in full, as long as $20,000 dollars of savings are realized as a result of the
Cigna audit. In addition, "HCDM" will receive 35% of the total recovered dollars in the
form of refunds, credits, adjustments, and/or, settlements as a result of their work. These
additional dollars will only be paid as long as recovered dollars are identified and
recouped by "HCDM". In turn, the City would realize savings of 65% of dollars
uncovered to be paid in error by Cigna and recouped by "HCDM".
BACKGROUND
RFLI 02-03-241 for a Health Care Provider to perform a comprehensive retrospective
claims audit, hospital bill audit, DRG Validation, fraud and abuse detection, coordination
of benefits, and third party liability reviews for the City of Miami's medical plan
currently administered through Cigna. The successful proposer shall also determine
whether Cigna is indeed administering the plan per the plan document and contract. In
turn, this claims audit prepared by the successful proposer will be utilized by the
successful proposer to aggressively recoup any payments made by the City in error by
Cigna, if applicable.
LH:DC:RF