CSP018844_Amendment_1.pdf
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- Attached to
- Competitive Selection OH|CSP018844
- Contract number
- CSP018844
- Issued by
- Ohio
About this file
This document is Amendment No. 1 to a mandatory use contract for Surprise Billing—Arbitration Entity Services issued by the State of Ohio, Department of Administrative Services, General Services Division, Office of Procurement Services. The amendment involves Federal Hearings and Appeal Services (located in Plymouth, PA) as the contracted arbitration entity, with the Ohio Department of Insurance as the primary agency utilizing the contract.
The contract covers arbitration services for surprise billing claims, with an all-inclusive flat fee of $427.71 per arbitrated claim. The amendment extends the contract for a twenty-four (24) month renewal period from January 1, 2025 through December 31, 2026, maintaining the same pricing structure. The contractor will be solely responsible for collecting arbitration fees from participating entities, and no additional reimbursement will be provided for travel or related expenses. The contract was originally solicited through Request for Proposal (RFP) No. SRC0000012940 and is available for reference on the DAS website at www.ohio.gov/procure.
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| File | Type | Posted |
|---|---|---|
| CSP018844_Contract_REV.pdf |
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Text version
Index No.: INS011 Contract No.: CSP018844 Eff. Date: 1/01/25
STATE OF OHIO
DEPARTMENT OF ADMINISTRATIVE SERVICES
GENERAL SERVICES DIVISION
OFFICE OF PROCUREMENT SERVICES
4200 SURFACE ROAD, COLUMBUS, OH 43228-1395
AMENDMENT FOR CHANGE
AMENDMENT NO. 1
TO: LIMITED DISTRIBUTION - OHIO DEPARTMENT OF INSURANCE
FROM: KATHLEEN C. MADDEN, DIRECTOR, DEPARTMENT OF ADMINISTRATIVE SERVICES
SUBJECT: CONTRACT FOR SURPRISE BILLING—ARBITRATION ENTITY SERVICES
Attached are pages 1, 3 and 5 to this contract. Remove these pages from the existing contract and replace with the attached pages on the effective date.
As a result of mutual agreement between the State of Ohio and the Contractor, this amendment is issued to renew the subject contract an additional twenty-four (24) months, effective January 1, 2025 through December 31, 2026.
Additionally, this amendment is issued to insert the renewal period cost and adds the Summary of Amendments page to the contract.
All other prices, terms and conditions remain unchanged.
This Amendment, the Contract and any additional Amendments thereto are available from the DAS Web site at the following address:
http://www.ohio.gov/procure
Affected Contractor(s):
0000259635 Federal Hearings and Appeal Services 117 W. Main St.
Plymouth, PA 18651 jbobeck@fhas.com
Eff. Date: 01/01/25 Page No.: 1
STATE OF OHIO
DEPARTMENT OF ADMINISTRATIVE SERVICES
GENERAL SERVICES DIVISION
OFFICE OF PROCUREMENT SERVICES
4200 SURFACE ROAD, COLUMBUS, OH 43228-1395
MANDATORY USE CONTRACT FOR: SURPRISE BILLING—ARBITRATION ENTITY SERVICES
CONTRACT NUMBER: CSP018844 EFFECTIVE DATES: 01/01/24 TO 12/31/24
* Renewal through 12/31/26
The Department of Administrative Services has accepted Proposals submitted in response to Request for Proposal (RFP) No.
SRC0000012940 that opened on 10/25/23. The evaluation of the Proposal responses has been completed. The Offeror listed herein has been determined to be the highest ranking Offeror and has been awarded a Contract for the services listed. The respective Proposal response including, Contract Terms & Conditions, any Proposal amendment, special Contract Terms & Conditions, specifications, pricing schedules and any attachments incorporated by reference and accepted by DAS become a part of this Services Contract.
This Requirements Contract is effective beginning and ending on the dates noted above unless, prior to the expiration date, the Contract is renewed, terminated, or cancelled in accordance with the Contract Terms and Conditions.
This Requirements Contract is available to the Ohio Department of Insurance as applicable.
The agency is eligible to make purchases of the contracted services in any amount and at any time as determined by the agency. The State makes no representation or guarantee that department will purchase the volume of services as advertised in the Request for Proposal.
This Requirements Contract and any Amendments thereto are available from the DAS Web site at the following address:
www.ohio.gov/procure
*Indicates a twenty-four (24) month renewal, effective January 1, 2025 through December 31, 2026
COST SUMMARY
Surprise Billing – Arbitration Entity Services
CSP018844
UNSPSC CATEGORY CODE: 80000000, 80122001
DESCRIPTION
UNIT OF
MEASURE
ALL-INCLUSIVE FLAT FEE
(CONTRACT INCEPTION
THROUGH 12/31/24)
*ALL-INCLUSIVE FLAT FEE
(01/01/25 THROUGH
12/31/26)
Arbitrated claim (completed) [Flat fee includes all scope of work activities and deliverables.]
EACH
$427.71
$427.71
All costs must be in U.S. Dollars.
The State will not be responsible for any costs not identified.
There will be no additional reimbursement for travel or other related expenses.
The Contractor will solely be responsible for collecting arbitration fees from participating entities.
*Indicates insertion of renewal period and associated cost
*SUMMARY OF AMENDMENTS
Amendment Number
Effective Date Description
1 01/01/25
This Amendment is issued to notify that as a result of mutual agreement between the State of Ohio and the Contractor, this contract shall be renewed for a period of twenty-four (24) months, effective January 1, 2025 through December 31, 2026. Additionally, this amendment is issued to insert the renewal period cost and adds the Summary of Amendments page to the contract. All other prices, terms and conditions remain unchanged.
*Indicates adding the Summary of Amendments page
| CONTRACT FOR: SURPRISE BILLING—ARBITRATION ENTITY SERVICES |
| *SUMMARY OF AMENDMENTS |
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