HomeMy WebLinkAboutExhibit 1agency for persons with disabilities
State of Florida
MEDICAID WAIVER SERVICES AGREEMENT
GENERAL TERMS AND CONDITIONS
This Agreement is entered into between the Florida Agency for Persons with Disabilities, hereinafter referred
to as "APD", and City of Miami -Parks & Recreation, hereinafter referred to as the "Provider". The Provider
agrees to provide Transportation Services under the Florida Medicaid Developmental Disabilities Home and
Community -Based Waiver Program to eligible recipients.
I. AGREEMENT DOCUMENTS
A. The Medicaid Waiver Services Agreement consists of the General. Terms and Conditions and the following
documents:
Core Assurances as described in the current Developmental Disabilities Waiver Services Coverage
and Limitations handbook are incorporated into this agreement by reference.
Transportation Services Reporting Example (Attachment A).
Rate Structure documents are incorporated into this Agreement by reference (Attachment B).
The Developmental Disabilities Waiver Services Coverage and Limitations Handbook, listing
requirements for specific services, is incorporated into this Agreement, by reference.
B. Prior to providing any services the provider must, in order to be compensated by the Developmental
Disabilities Horne and Community -Based Waiver Program, execute a Medicaid Provider Agreement with the
Agency for Health Care Administration (AHCA), and be issued a Medicaid provider number by AHCA. The
provider must at all times maintain a current and valid Medicaid Provider Agreement with AHCA, . The provider.
must comply with the terms and conditions of the Medicaid Provider Agreement.
II. THE PROVIDER AGREES:
To comply with all of the terms and conditions contained within the Agreement documents attached and those
contained in the Developmental Disabilities Waiver Services Coverage and Limitations Handbook for specific
services rendered by the provider, and to report transportation services data to the APD. The data shall be
collected during the first quarter of each calendar year and reported on or before June 1 of each year in the
manner and: format determined by APO.
A. Monitoring, Audits, Inspections, and investigations
1. To permit persons duly authorized by the Agency for Persons with Disabilities, the Agency for Health
Care Administration or rc=']resentatives of either, to monitor, audit, investigate and inspect any recipient
records, payroll and exp. •diture records (including electronic storage media) papers, documents,
facilities, goods and servicbs of the provider which are relevant to this Agreement, and to interview any
recipients receiving services and employees of the provider to assure APD of the satisfactory
performance of the terms and conditions of this Agreement.
2. Following such evaluation, the APD or its authorized representative, will furnish to the provider a written
report of its findings and request for development, by the provider, of a Quality Improvement Plan (QiP)
for needed corrections. The provider hereby agrees to correct ail noted deficiencies identified by the
APD, AHCA, or their authorized representatives within the specified period of time identified within the
report documentation. Failure to correct noted deficiencies within stated time frames may result in
termination of this agreement.
3. Upon demand, at no additional cost to the APD, AHCA, or their authorized representatives, the
provider will facilitate the duplication and transfer of any records or documents (including electronic
storage media), during the required retention period of five years after termination of the Agreement, or
if an audit has been initiated and audit findings have not been resolved at the end of five years, the
October 20A3: Revised December 2004;Revised September 29, 2005
1
Agency for Persons with Disabilities Medicaid Waiver Services Agreement
records shall be retained until resolution of the audit findings or any litigation which may be based on
the terms of this Agreement, at no additional cost to APD.
4. To comply and cooperate immediately with APD requests for information, records, reports, and
documents deemed necessary to establish methods to review the rate setting process to ensure that
provider rates are based on accurate information and reflect the existing operational requirements of
each service. Any individual who knowingly misrepresents the information required in rate setting
commits a felony of the third degree, punishable as provided in Chapters 775.082-083, 775.044, F.S.
5. To comply and cooperate immediately with any inspections by APD, reviews, investigations or audits
deemed necessary by the Office of the Inspector General (Section 20.055, F,S.).
6. To include the aforementioned audit, inspections, investigations and record keeping requirements in all
subcontracts and assignments.
B. Indemnification
1. To be liable for and indemnify, defend, and hold the Agency for Persons with Disabilities, the Agency for
Health Care Administration and all of their officers, agents, and employees harmless from all claims, suits,
judgments, or damages, including attorneys' fees and costs, arising out of any act, actions, neglect, or
omissions by the provider, its agents, or employees during the performance or operation of this Agreement
or any subsequent modifications thereof, whether direct or indirect, and whether to any person or tangible
or intangible property.
2. That its inability to evaluate its liability or its evaluation of liability shall not excuse the provider's duty to
defend and to indemnify within seven days after notice by APD by certified mail. After the highest appeal
taken is exhausted, only an adjudication or judgment specifically finding the provider not liable shall excuse
performance of this provision. The provider shall pay all costs and fees, including attorneys' fees related to
these obligations and their enforcement by APD. The APD's failure to notify the provider of a claim shall
not release the provider of these duties. The provider shall not be liable for negligence, which is solely that
of the Agency for Persons with Disabilities.
C. Insurance
To obtain and maintain at all times liability insurance coverage, as required by state or federal law or by this
Agreement;
D. Return of Funds
To be responsible for the timely correction of all billing or reimbursement errors resulting in an overpayment,
including reimbursement for services not properly authorized or documented, Reimbursement will be made
pursuant to the Florida Medicaid Provider Reimbursement Handbook Non -Institutional 081. Federal
regulations, 42 CFR 433.312, require refund of overpayments within 60 days of discovery.The AHCA will be
the final authority regarding the timeliness of the reimbursement process.
III. FINES AND PENALTIES
1. In accordance with the provisions of Section 402.73(7), Florida Statutes, and Section 65-29.001, Florida
Administrative Code, penalties may be imposed for failure to implement or to make acceptable progress on
such quality improvement plans as specified in Section II. A. of this Agreement.
2. The increments of penalty imposition that shall apply, unless APD determines that extenuating
circumstances exist, shall be based upon the severity of the non-compliance, non-performance or
unacceptable performance that generated the need for a quality improvement plan. The penalty, if
imposed, shall not exceed ten percent of the total billed by the provider for services during the period in
which the quality improvement plan has not been implemented, or In which acceptable progress toward
implementation has not been made. This period is defined, as the tirne period from receipt of the report of
findings to the time of the follow-up determination that correction or progress toward improvement has not
been made.
3. Non-compliance that is determined to have a direct effect on individual health and safety shall result in the
imposition of a ten percent penalty of the total payments billed by the provider during the period in
2 October 2003; Revised December 2004
Revised September 29, 2005
Agency for Persons with Disabilities Medicaid Waiver Services Agreement
which the quality improvement plan has not been implemented or in which acceptable progress toward
implementation has not been made.
4. Non-compliance involving the provision of training responsibilities or direct service to the individual not
having a direct effect on individual health and safety shall result in the imposition of a five percent penalty.
Non-compliance as a result of unacceptable performance of administrative tasks, such as policy and
procedure development, shall result in the imposition of a two percent penalty.
5. In the event of non-payment, APD will request the AHCA deduct the amount of the penalty from claims
submitted by the provider for the covered time period.
IV. TERMINATION
A. This Agreement may be terminated by either party without cause, upon no less than thirty calendar days
notice in writing to the other party unless a lesser time is mutually agreed upon in writing by both parties. Said
notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery.
B. This Agreement may be terminated for the provider's non-performance or misconduct upon no less than
twenty-four hours notice in writing to the provider. Waiver by either party of any breach of any term or condition
of this Agreement shall not be construed as a waiver of any subsequent breach of any term or condition of this
Agreement. If APD determines that the provider is not performing in accordance with any term or condition in
this agreement, the APD may, at its exclusive option, allow the provider a period of time to achieve compliance.
The provisions herein do not limit APD's right to any other remedies at law or in equity.
V. GOVERNING LAW
This Agreement shall be construed, performed, and enforced in all respects in accordance with all the laws,
rules, and regulations of the State of Florida, and any applicable federal laws, rules, and regulations.
VI. AGREEMENT DURATION
This Agreement shall be effective. November 1, 2005, or the date on which it has been signed by both parties,
whichever is later, and shall terminate on 06/30/08 which is no later than three years from the effective date.
VII. INDEPENDENT STATUS
The provider agrees that it acts at all times in the capacity of an independent service provider and not as an
officer, employee, or agent of the Agency for Persons with Disabilities or the Agency for Health Care
Administration or the State of Florida. The provider shall not represent to others that it has the authority to bind
the APD or AHCA unless specifically authorized in writing to do so. In addition to the provider, this is also
applicable to the provider's officers, agents, or employees in performance of this Agreement.
VIII. OFFICIAL REPRESENTATIVES (Names, Addresses, and Telephone Numbers):
1. The name and telephone number of the provider's contact person and street address where financial and
administrative records are maintained is:
Name:
Telephone Number:
Address:
October 2003; Revised December 2004, Revised September 29, 2005
3
Agency for Persons with Disabilities Medicaid Waiver Services Agreement
2. The name, address, and telephone number of the representative of the provider responsible for
administration of the service(s) under this Agreement is:
Name:
Telephone Number:
Address:
3. The name, address, and telephone number of the Agency for Persons with Disabilities contact person for
this Agreement is:
Name: Hillary Jackson, Operations & Management Consultant— Medwaiver
Telephone Number: (305) 808-6251
Address: 401 NW 2nd Avenue, Suite S —811, Miami FL 33128
4. Upon change of representative's names, addresses, and telephone numbers, by either party, notice shall
be provided in writing to the other party and the notification attached to the originals of this Agreement.
X. INTEGRATED AGREEMENT
Only these General Terms and Conditions, the Core Assurances, attachment as referenced, the Medicaid
Provider Agreement and the Developmental Disabilities Waiver Services Coverage and Limitations Handbook,
which is incorporated into this Agreement by reference, contain all the terms and conditions agreed upon by the
parties.
There are no provisions, terms, conditions, or obligations other than those contained herein, and this
Agreement shall supersede all previous communications, representations, or agreements, either verbal or
written between the par es. If any_term or provision of the Agreement is found to be illegal or unenforceable,
the remainder of the Agreement shall remain in full force and effect and suclf term -or provision shall be
stricken.
If an existing Medicaid Waiver Services Agreement includes other services in addition to Transportation
Services, this Agreement will only supersede the Transportation Services portion of the previous Agreement.
All other services will continue under the terms of the previous Agreement.
The provider, by signing below, attests that the provider has received and read the entire Agreement,
, the service -specific
inclusive of Its attachment's and documents as referenced, listed in Section 1, A.
requirements for enrolled providers, contained in the Developmental Disabilities Waiver Services
Coverage and Limitations Handbook, and understands each section and paragraph.
IN WITNESS THEREOF, the parties hereto have caused this a page Agreement to be executed by their
undersigned officials as duly authorized.
STATE OF FLORIDA,
AGENCY FOR PERSONS WITH DISABILITIES
SIGNED
BY:
NAME: Evelyn ALvarez
TITLE: Program Administrator
DATE:
4
r
October 2003; Revised December 2004
Revised September 29, 2005
PROVIDER:
City of Miami Executive Officer
Joe Arriola
Name (typed)
ATTEST:
By:
Name/Title
Priscilla A. Thompson, City Clerk
Name (typed)
APPROVED AS TO
INSURANCE REQUIREMENTS
By: l j d'of'
is�� trator
City Risk Management Admi
Dania Carrillo
Name (typed)
By: City Manager
Title
By:
(Corporate Seal)
APPROVED AS TO FORM
AND CORRECTNESS
By:
City Attorney
Jorge L. Fernandez
Name (typed)