CN-680000-ME210-A4.pdf

AHCA CONTRACT NO. MED210

AMENDMENT NO. 4

AHCA Contract No. MED210, Amendment No. 4, Page 1 of 6 April 2020

THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the "Agency" and MYERS AND STAUFFER LC, hereinafter referred to as the "Vendor," is hereby amended as follows:

1. In accordance with Standard Contract, Section I., The Vendor Hereby Agrees, Sub-

Section W., Requirements of Section 287.058, Florida Statutes, Item 6, which provides for renewal of this Contract for a period that may not exceed three (3) years or the original term of this Contract, whichever is longer, both Parties hereby agree to exercise the first renewal option for a period of three (3) years beginning July 1, 2023. Therefore, Item 5 is hereby amended to now read as follows:

This Contract shall begin July 1, 2020, and end on June 30, 2026, inclusive.

2. Standard Contract, Section II, The Agency Hereby Agrees, Sub-Section A., Contract Amount, is hereby amended to now read as follows:

To pay for contracted services according to the conditions of Attachment I, Scope of Services, in an amount not to exceed $6,835,668.00, subject to the availability of funds.

The State of Florida's performance and obligation to pay under this Contract is contingent upon an annual appropriation by the Legislature.

3. Standard Contract, Section III, The Vendor and Agency Hereby Mutually Agree, Item

B., Contract Managers, sub-item 1., is hereby amended to now read as follows:

1. The Agency’s Contract Manager’s contact information is as follows:

Kiana Redding Agency for Health Care Administration 2727 Mahan Drive, MS #23 Tallahassee, Florida 32308

(850) 412-4274 Kiana.Redding@ahca.myflorida.com

4. ATTACHMENT I, Scope of Services, Section I., Service(s) to be Provided, Sub-Section

B, Overview/Purpose, is hereby amended to create Item 9., Worksheet S-10 Reconciliations, which reads as follows:

9. Reconcile Worksheet S-10 hospital uninsured charity care costs with detailed LIP cost limit data.

5. ATTACHMENT I, Scope of Services, Section II., Manner of Service(s) Provision, Sub-

Section B, Services Provided by the Vendor, adds Item 17, Worksheet S-10 Reconciliation, which reads as follows:

17. Worksheet S-10 Reconciliation

a. The Vendor shall perform a reconciliation of Worksheet S-10 uninsured charity care costs with detailed LIP cost limit data.

b. The Vendor shall review and identify claims included in Worksheet S-10, DocuSign Envelope ID: 9B38F76B-5C76-4D6F-93B6-D4D4B7312D4A

AHCA Contract No. MED210, Amendment No. 4, Page 2 of 6 excluded from LIP cost limit data as well as identify claims excluded from Worksheet S-10 included in LIP cost limit data based on claims level detail.

The vendor shall also identify claims included in both data sets, but with different charge amounts.

c. The Vendor shall review the query logic utilized by the hospital for

Worksheet S-10 and LIP cost limit data and identify variances.

d. The Vendor shall select claim samples for variances noted between the data claim charges, date of service, write off date, and hospital place of service for the claim. The Vendor shall determine the cause of the variances between the data sets.

e. For each completed Worksheet S-10 review, the Vendor shall submit working papers and findings to the Agency.

f. The Vendor will quantify the variances between the data sources and determine whether adjustments are necessary.

6. ATTACHMENT I, Scope of Services, Section II, Manner of Services(s) Provision, Sub-

Section B, Services Provided by the Vendor, Item 7, Vendor Qualifications, Sub-Item e., is hereby amended to now read as follows:

e. Have the organizational structure and operational capacity to complete LOA and at least fifty (50) Worksheet S-10 reconciliations, at least three hundred (300) provider LIP Cost Limit initial reviews and at least three hundred (300) provider LIP Cost Limit reconciliations, and one (1) final LIP Cost Limit Reconciliation report each contract year.

7. ATTACHMENT I, Scope of Services, Section II, Manner of Service(s) Provision, Sub-

Section B, Services Provided by the Vendor, Item 16, Ad Hoc Project, Table 1 is hereby deleted in its entirety and replaced with Table 1-A, to now read as follows:

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

AHCA Contract No. MED210, Amendment No. 4, Page 3 of 6

TABLE 1-A

AD HOC PROJECT: LIP/DSH Payment Assistance

SUPPORTING DOCUMENTATION

For each approved ad-hoc project, the Vendor shall submit a written plan to be approved in writing as outlined in Attachment I, Scope of Services, Section II Manner of Service(s) Provision, Sub-Section D., Reporting All working papers must be submitted with the deliverable as outlined in Attachment I, Scope of Services, Section II., Manner of Service(s) Provision, Sub-Section D., Reporting.

EVALUATION CRITERIA

Completion of the approved project plan and submitted with all required supporting documentation. The Agency will track progress of the completion of the project plan tasks through the Vendor’s submission of updated timelines with the Monthly Report.

DUE DATE(S)

Task

Description of Ad- Hoc

Task Due Dates Unit Cost

1 Compare calculated hospital LIP payments to the most recent audited cost limits to identify providers with potential overpayments.

Ongoing, no later than 6/30 of each contract year

$99.50 hourly rate

2 Contact providers identified with potential overpayments to determine whether uninsured charity care costs increased over most recent audited amounts.

Ongoing, no later than 6/30 of each contract year

$99.50 hourly rate

3 Based on calculated hospital LIP payments, anticipated directed payments and DSH examination results, calculate DSH limits and reallocate DSH payments by pool prior to DSH payment to limit the potential for provider overpayments.

Ongoing, no later than 6/30 of each contract year

$99.50 hourly rate

4 Calculate LIP/DSH redistributions for demonstration years, if applicable.

Ongoing, no later than 6/30 of each contract year

$99.50 hourly rate

AHCA Contract No. MED210, Amendment No. 4, Page 4 of 6

5 Review FQHC, medical schools, and CBHC LIP uncompensated care estimates and compare sources to most recent audited cost limit data.

Identify variance causes and work with industry to align estimates with cost limit requirements.

Ongoing, no later than 6/30 of each contract year

$99.50 hourly rate

6 Provide assistance to the Agency regarding DSH regulatory revisions, LIP Special Terms and Conditions and RFMD revisions as needed.

Ongoing, no later than 6/30 of each contract year

$99.50 hourly rate

7 IGT Letter of Agreement Questionnaire Review

Ongoing, no later than 6/30 of each contract year

$99.50 hourly rate

AMOUNTS

Unit cost per documented completion of approved tasks as detailed above.

PERFORMANCE STANDARDS

The Vendor shall submit one final report documenting and compiling all approved ad-hoc analyses, reports, and technical assistant provided.

Contract Year. The Vendor shall submit the deliverable in accordance with the description provided in Attachment I, Scope of Services, Section II., Manner of Service(s) Provision, Sub-Section D., Reporting.

LIQUIDATED DAMAGES

Please see Attachment I, Scope of Services, Section III., Method of Payment, Sub-Section D., Financial Consequences as Liquidated Damages, Table 1, Performance Standards and Liquidated Damages, for the appropriate liquidated damage that will be imposed.

8. ATTACHMENT I, Scope of Services, Section III., Method of Payment, Sub-Section A, Payment, is hereby amended to now read as follows:

This Contract is a fixed price (unit cost) Contract in the amount of $6,835,668.00 for the term of this Contract. The Agency reserves the right to modify the Contract amount based on need. The Agency in its sole discretion shall make this determination.

The Vendor shall be compensated based on a unit cost basis in accordance with Attachment I, Scope of Services, Exhibit A, Deliverables. The Agency will pay the Vendor in arrears payments for each completed LIP Cost Limit examination, each completed Worksheet S-10 reconciliation or completed initial review of each provider.

AHCA Contract No. MED210, Amendment No. 4, Page 5 of 6 April 2020

The Vendor shall not be paid for any outstanding invoices, including the final invoice, until the working papers for all open assignments are received by the Agency.

The Agency will compensate the Vendor for LIP Cost Limit examination, Worksheet S-10 reconciliation or initial review completed for cancelled examinations up to the point of the Agency’s notification of cancellation based on the predetermined hourly rate.

All payments to the Vendor are inclusive of all administrative and travel fees. The Agency shall not pay and/or reimburse the Vendor separately for administrative fees and/or travel costs.

9. Attachment I, Exhibit A, Deliverable 3, Intergovernmental Transfer (IGT) Reviews, Evaluation Criteria, is hereby amended to read as follows:

Completion of the anticipated fifty (50) Worksheet S-10 reconciliations per year submitted with all required supporting documentation. The Agency will track progress of the completion of examinations through the Vendor’s submission of updated timelines with the Monthly Report.

10. Attachment I, Exhibit A, Deliverables, Deliverable 3, Intergovernmental Transfer (IGT)

Reviews, Amount, is hereby amended to read as follows:

Unit cost per documented completion of each Worksheet S-10 reconciliation.

$224,250.00 annually based on a unit cost of $4,485.00 per unit up to fifty (50) units per

Contract year.

11. Attachment I, Exhibit A, Deliverables, Deliverable 3, Intergovernmental Transfer (IGT) Reviews, Performance Standards, is hereby amended to read as follows:

The Vendor shall perform up to fifty (50) Worksheet S-10 reconciliations per year of this Contract, unless otherwise directed by the Agency in writing.

All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in this Contract.

This Amendment and all its attachments are hereby made a part of this Contract.

This Amendment cannot be executed unless all previous Amendments to this Contract have been fully executed.

AHCA Contract No. MED210, Amendment No. 4, Page 6 of 6

IN WITNESS WHEREOF, the Parties hereto have caused this six (6) page Amendment to be executed by their officials thereunto duly authorized. This Amendment is not valid until signed and dated by both Parties.

MYERS & STAUFFER LC STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION

SIGNED

BY:

SIGNED

BY:

NAME: NAME:

TITLE: TITLE:

DATE: DATE:

Member

6/30/2023

Robert Hicks

Chief of Staff

Stefan Grow

6/30/2023