CN-680000-ME210-A5.pdf

AHCA CONTRACT NO. MED210

AMENDMENT NO. 5

AHCA Contract No. MED210, Amendment No. 5, Page 1 of 3 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 II., THE AGENCY HEREBY AGREES, Sub-Section A., Contract Amount, the first sentence 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 $7,729,974.00 (an increase of $894,306.00) subject to the availability of funds.

2. 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., is hereby amended to add Table 2 and read as follows:

TABLE 2

AD HOC PROJECT: PEMT Program Cost Reports

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 Provide Training and Guidance

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

$ 99.50 hourly rate

2 Web Portal Submissions and Maintenance

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

$ 99.50 hourly rate

3 Perform agreed-upon procedure reviews of PEMT cost reports and calculate final PEMT settlements

Ongoing, no later than 6/30 of each

$ 99.50 hourly rate

DocuSign Envelope ID: 551CC68B-B98E-4333-A6C0-F61CFC4D8C8B

AHCA Contract No. MED210, Amendment No. 5, Page 2 of 3 contract year

4 Calculate PEMT redistributions, if applicable.

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

$ 99.50 hourly rate

5 Assist the Agency regarding PEMT regulatory revisions.

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

$ 99.50 hourly rate

6 Calculate final CPE for AHCA 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.

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.

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

AHCA Contract No. MED210, Amendment No. 5, Page 3 of 3

IN WITNESS WHEREOF, the Parties hereto have caused this three (3) 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:

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

Member

Robert Hicks

11/16/2023 12/15/2023

Secretary

Jason Weida