HomeMy WebLinkAboutSacramento Metropolitan Fire District; 2023-10-10;AGREEMENT FOR RECOVERY OF ADMINISTRATIVE COSTS
FOR IMPLEMENTATION AND RECOVERY OF GROUND EMERGENCY
MEDICAL TRANSPORTATION PAYMENTS
This agreement is made and entered into on this __ day of _______ _, 20 __ , between
the Sacramento Metropolitan Fire District ("Metro Fire"), a political subdivision of the State of California
and _____________ ("GEMT Transporter").
WHEREAS, the State Department of Health Care Services ("State") has developed and is
administering the Medi-Cal Ground Emergency Transportation Supplemental Reimbursement Program
pursuant to the California Welfare and Institutions Code Section 14105.94 ("State Code") and State Plan
Amendments ("SPA") 09-024; and,
WHEREAS, the State has entered into an agreement with Metro Fire for administrative services
related to the Medi-Cal Ground Emergency Transportation Supplemental Reimbursement Program
pursuant to the State Code and SPA 09-024 ("State Agreement"), which is attached hereto as Exhibit A,
and is incorporated as if set forth fully herein; a_nd,
WHEREAS under the State Code an eligible provider of ground emergency medical transportation
services may be entitled to supplemental Medi-Cal reimbursement as set forth in those provisions; and,
WHEREAS an eligible provider as described in the State Code is required to enter into an agreement
to reimburse the State for implementing and administering the Supplemental Reimbursement Program
as a condition of receiving supplemental reimbursement pursuant to the State Code; and,
WHEREAS pursuant to the State Agreement, Metro Fire has been designated by the State to
recover the administrative and implementation costs required to be paid by eligible providers under the
State Code; and,
WHEREAS Metro Fire will incur administrative and other costs in connection with billing GEMT
Transporter for costs, and has assumed the risk of payment, or non-payment of the costs from GEMT
Transporter;
NOW therefore, the Parties enter into this Agreement for the purpose of setting forth the manner
and terms for payment of administrative costs by the eligible GEMT providers to Metro Fire, under the
following terms and conditions.
I.PARTIES
Metro Fire is a designated agency for the collection of costs related to the GEMT Supplemental Medi-Cal
Reimbursement Program. GEMT Transporter is an eligible provider of GEMT services as described in the
State Code.
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10th October 23
City of Carlsbad
11. TERMS
This Agreement shall be effective and commence as of July 1, 2022 and shall end on June 30,
2023. However, GEMT transporter acknowledges and agrees that cost reports submitted by
GEMT Transporters are subject to audit by the State of California for a period of up to three years
from the date of submission of the reports by the GEMT Transporter to the State of California, or
such other final settlement period as specified in a subsequent SPA. During that period of time,
State administrative costs as defined in the State Code will continue to be incurred by the State
for which the GEMT Transporter agrees to pay to Metro Fire pursuant to Section IV below. The
GEMT Transporter agrees to pay its transporter share of administrative costs pursuant to Section
V. after the termination of this Agreement, whether this Agreement is terminated by its term, or
in the event GEMT Transporter elects to terminate the Agreement, or in the event that Metro
Fire te(minates the Agreement.
Ill. RATIFICATION
Where there has been a need for Metro Fire to provide services essential to the GEMT program
in the State of California and where such services have been provided prior to the date of
execution of this Agreement, both Parties agree that the calculation, and payment, of services
under this Agreement shall begin on July 1, 2018.
IV. SCOPE OF SERVICES AND RESPONSIBILITIES
Metro Fire will provide the following services:
A. Advance of GEMT administration costs to the State as provided by SPA 09-024 on
behalf of the GEMT Transporter
B. Administration of recovery of costs from GEMT Transporters
The GEMT Transporter will provide the following services:
A. Accurate reports of transports eligible under the GEMT program
B. Accurate record keeping and retention of records for a period of not less than
seven (7) years
C. Provide all records upon request for audit purposes
V. PAYMENT TERMS
GEMT Transporter agrees to pay Metro Fire the transporter's share of the State administrative
costs as defined in the State Code. The GEMT transporter share will be based upon the
administrative costs per fee for service Medi-Cal transport, multiplied by the GEMTTransporter's
number of fee for service Medi-Cal transports for each reporting period. The administrative costs
per fee for service Medi-Cal transport will be determined based on the total administrative costs
of the State in administering the GROUND EMERGENCY MEDICAL TRANSPORTATION SERVICES
SUPPLEMENTAL REIMBURSEMENT PROGRAM divided by the total number of fee for service
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Medi-Cal transports statewide by all participating transporter agencies for each reporting period.
Should Metro Fire be required to reimburse the State for administrative costs prior to the
submission of cost reports in any given reporting period, the most recently completed cost
reports shall be the basis for determining which agencies are considered participating
transporting agencies. In addition, the GEMTtransporter will compensate Metro Fire one percent
(1%) of the GEMT transporter's gross State Supplemental Reimbursement of GEMT services
under the State Code for each reporting period for Metro Fire's administrative services, cost of
advancing funds for the State, and the risk of non-payment from GEMT Transporters.
A. Metro Fire will notify, via email, the amount due under Section V. of this
Agreement by the GEMT Transporter once the amount is determined
B. All amounts due under this Agreement will be paid to Metro Fire no later than 30
days after the first notification is sent to the GEMT Transporter via one of the
following methods: ACH/EFT, warrant from Invoice, or Credit Card
C. Non-payment by the GEMT Transporter constitutes a breach of this Agreement
and, if not cured, will result in a termination of this Agreement pursuant to Section
XII below
a. A breach of this Agreement may be cured by the successful completion of
the payment transaction to Metro Fire by GEMT Transporter within 30
days' notice by Metro Fire
b. The State will not provide GEMT supplemental reimbursements to the
GEMT Transporter without a valid Agreement for Recovery of
Administrative Costs for Implementation and Recovery of GEMT Payments
with Metro Fire
VI. REIMBURSEMENT COSTS ACKNOWLEDGMENT
The GEMT Transporter acknowledges and agrees that the compensation paid to Metro Fire
pursuant to this Agreement is intended to cover the costs for administering the supplemental
reimbursement program under Section 14105.94(d) of the State Code. The compensation
payable to Metro Fire is approved by the State, pursuant to the State Agreement attached as
Exhibit A. The GEMT Transporter hereby agrees to waive any claim, action, or challenge to the
payment method for the collection of costs under Section 14105.94(d) of the State Code, in the
manner set forth in this Agreement.
VII. DISPUTE RESOLUTION
In the event of a dispute between the Parties in the terms of this Agreement as to any issue
arising under this Agreement, the Parties agree to meet and negotiate in good faith to resolve
such dispute. This shall not limit the Parties' right to pursue any available remedies at law or in
equity.
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VIII. MUTUAL INDEMNIFICATION
It is agreed that the GEMT Transporter shall defend, hold harmless and indemnify Metro Fire, its
officers, employees, and agents from any and all claims, liability, loss or expense (including
reasonable attorney fees and costs) for injuries or damage to any person and/or any property
which arise out of the terms and conditions of this Agreement and the negligent or intentional
acts or omissions of the GEMT Transporter and its officers, employees or agents. It is further
agreed that Metro Fire shall defend, hold harmless and indemnify the GEMTTransporter and its
officers, employees, and agents from any and all claims, liability, loss or expense (including
reasonable attorney fees and costs) for injuries or damage to any person and/or any property
which arise out of the terms and conditions of this Agreement and the negligent or intentional
acts or omissions of Metro Fire, its officers, employees, or agents.
IX. · SEVERABILITY
If any term, condition, or provision of this Agreement is held by a court of competent jurisdiction
to be invalid, void, or unenforceable, the remaining provisions will nevertheless continue in full
force and effect, and shall not be affected, impaired or invalidated in any way. Notwithstanding
the previous sentence, if a decision by a court of competent jurisdiction invalidates, voids, or
renders unenforceable a term, condition, or provision in this Agreement that is included in the
purpose of this Agreement then the Parties to this Agreement shall either amend this Agreement
pursuant to Section X, or it shall be terminated.
X. AMENDMENT AND WAIVER
Except as provided herein, no alteration, modification, amendment, variation, or waiver of the
terms of this Agreement shall be valid unless made in writing and signed by both Parties. Waiver
by either party of any default, breach or condition precedent shall not be construed as a waiver
of any other default, breach or condition precedent, or any other right hereunder.
XI. INTERPRETATION
This Agreement shall be deemed to have been prepared equally by bot~ of the Parties, and the
Agreement and its individual provisions shall not be construed or interpreted more favorably for
one party on the basis that the other party prepared it.
XII. TERMINATION
Either of the Parties may terminate this Agreement upon thirty (30) days written notice to the
other party. Notice shall be deemed served on the date of mailing. GEMT Transporter's
responsibility for administrative costs incurred by the State associated with transporter costs
reports and/or the State's audit of those costs shall survive the termination of the Agreement.
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XIII.PRIOR AGREEMENTS
This Agreement constitutes the entire Agreement between Metro Fire and GEMT Transporter
regarding the subject matter of this Agreement. Any prior agreements, whether oral or written,
between Metro Fire and GEMT Transporter regarding the subject matter of this Agreement are
hereby terminated effective immediately upon full execution of this Agreement.
XIV.INTEGRATION CLAUSE
This Agreement and any exhibits attached hereto shall constitute the entire Agreement among
the Parties to it and supersedes any prior or contemporaneous understanding or agreement with
respect to the services contemplated, and may be amended only by a written amendment
executed by both Parties to this Agreement.
XV.CONTROLLING LAW
The validity of this Agreement and its terms or provisions, as well as the rights and duties of the
Parties hereunder, the interpretation and performance of this Agreement shall be governed by
the laws of the State of California.
SACRAMENTO METROPOLITAN FIRE DISTRICT
Signature: _ __ _ _ Dave O'Toole, Chief Financial Officer
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c_tu�____,_,! 8'""--"n"--"a..;..>,<,.d,____ __ _ AGENCY NAME
Signature:
Printed Name: /J) , ·c2., _ tl �-/ _Ca-ldervvti od
Title: __ ri·,�c _ C,b__r_i�-P�--------
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Date:
Date:
10/09/2023
APPROVED AS TO FORM
Cindie McMahon, City Attorney
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Asslstan eputy Cfty Attorney
City of Carlsbad, California