Okaloosa County BOCC — 2013 meeting #1139 (date undetermined) — MEDICAID ORIGINAL 2009 — reading text

u. Contain a clause indemnifying, defending, and holding the AHCA, the Commission and the STP's Medicaid Beneficiaries harmless from and against all claims, damages, causes of action, costs or expense, including court costs and reasonable attorney fees, to the extent proximately caused by any negligent act or other wrongful conduct arising from the SlJbcontract: .. . . . ... ..... . .... . (1) This clause must survive the termination of the Subcontract, including breach due to Insolvency; and, (2) The Commission and/or AHCA may waive this requirement for itself, but not Medicaid Beneficiaries, for damages in excess of the statutory cap on damages for public entities if the Subcontractor is a public health entity with statutory immunity (the AHCA must approve all such waivers in writing). v. Where applicable, require that all Subcontractors secure and maintain, during the life of the Subcontract, worker's compensation insurance (complying with the Florida's Worker's Compensation Law) for all of its employees/independent contractors connected with the work under this Agreement unless such employees/independent contractors are covered by the protection afforded by the Recipient or Subcontractor. 2008/2009 Medicaid Non·Emergency Transportation Subcontracted Transportation Provider Contract Page 67 of 117  w. Make provisions for a waiver of those terms of the Subcontract, which, as they pertain to Medicaid Beneficiaries, are in conflict with the speCifications of this Agreement. x. Contain no provision that in any way prohibits or restricts the Subcontractor from entering into a contract with any other Vendor. y. Contain no provision requiring the Subcontractor to contract for more than one (1) transportation agreement or otherwise be excluded. z. Require Subcontractors to cooperate fully in any investigation by the AHCA or the Attorney General's Medicaid Fraud Control Unit (MFCU), or any subsequent legal action that may result from such an investigation. aa. Provide that the Commission, AHCA and DHHS may evaluate, through inspection or other means, the quality, appropriateness, and timeliness of the Transportation Services performed. bb. Provide the STP and the Commission with the ability to monitor the Subcontractor to ensure that all Transportation Providers are properly Licensed and inspected pursuant to State, county, and local statute and regulations. cc. Provide the Commission and STP with the ability to monitor and oversee all Transportation Services provided by Subcontractors to Medicaid Beneficiaries. dd. Identification of conditions and method of payment: (1) The STP agrees to make payment to all Subcontractors pursuant to all State and· federal laws, rules, and regulations,· specifically, Section 641.3155, F.S., 42 CFR 447.46, and 42 CFR 447.45(d)(2), (d)(3), (d)(5), and (d)(6); and, (2) Provide for prompt submission by the Subcontractor of all information and encounter data needed to make payment. ee.. Specify that if the Subcontractor delegates or Subcontracts any functions of the STP, that the Subcontract or .delegation includes all reqUirements of this Agreement. ft. Provide for revoking a previously Subcontracted delegation, or imposing other sanctions, if the Subcontractor's performance is inadequate. 3. STPjTransportation Provider Termination 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 68 of 117  a. The STP shall comply with all State and federal laws regarding Transportation Provider termination. In its Transportation Provider Agreements, the Recipient shall: (1) In addition to any other right to terminate the STP Agreement, and not withstanding any other provision of this Contract, the Commission may request immediate termination of a STP Agreement if, as determined by the Commission, a STP fails to abide by the terms and conditions of the STP Agreement, or in the sole discretion of the Commission, the STP fails to come into compliance with the STP contract within fifteen (15) Calendar Days after receipt of notice from the Commission specifying such failure and requesting such STP abide by the terms and conditions thereof; and, (2) If the Commission terminates a STP pursuant to any provision of the STP Contract, the STP shall use the applicable appeals procedures outlined in the STP Contract. There is no additional or separate right of appeal to the AHCA or the Commission as a result of the Commission's act of terminating, or decision to terminate any STP under this Contract. (3) The Commission shall provide sixty (60) Calendar Days' advance written notice to the STP before canceling, without cause, a STP Contract D. Transportation Provider Services· 1. General Provisions a. The STP shall provide sufficient information to all Transportation Providers in order to operate in full compliance with this Contract and all applicable federal, State, and local laws and regulations. b. The STP shall monitor each Transportation Provider to ensure that each Transportation Provider complies with the requirements of this Contract and all applicable federal, State, and local laws and regulations and shall take or require corrective actions to ensure compliance with such requirements. c. The Transportation Provider Agreements shall incorporate all provisions of the STPs agreement with the Commission (Subcontract), unless otherwise set forth below. 2. Transportation Provider Handbooks a. The Commission shall develop and· issue a Transportation Provider Handbook. All Transportation Provider Handbooks and bulletins shall be 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 69 of 117  in compliance with State and federal laws. The Transportation Provider Handbook shall serve as a source of information regarding Covered Services, policies and procedures, statutes, regulations, telephone access, and special requirements to ensure that all contract requirements are met. At a minimum, the Transportation Provider Handbook shall include the following information: (1) Description of the Non-Emergency Transportation program; (2) Covered Services; (3) Information about the Grievance System, the timeframes and requirements, the availability of assistance in filing, the toll-free numbers and the Medicaid Beneficiary's right to request continuation of Transportation Services while utilizing the Grievance System; (4) Routine, Hospital/facility discharges, Urgent Care, Emergency room/facility discharges, and will call policies and procedures; (5) The Cultural Competency Plan; (6) Medicaid Beneficiary rights and responsibilities (see 42 CFR 438.100 for guidance as to a Medicaid Beneficiary's rights and responsibilities); and, (7) Other Transportation Provider responsibilities. b. Bulletins shall be disseminated as needed to incorporate any changes or updates to the Transportation_. Provider. Handbook. 3. Education and Training a. STPs shall attend and/or participate in training and educational workshops when scheduled by the Commission. E. Medicaid Beneficiary Eligibility Records Requirements 1. The STP shall maintain records, either electronically or by hard copy, for each Medicaid Beneficiary in accordance with this Section. a. The STP's Medicaid BenefiCiary eligibility records must include all Encounter Data elements as set forth in the Encounter Data Section. At a minimum, the STP's Medicaid Beneficiary eligibility records must include the following: (1) Each record must be legible and maintained in detail; 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 70 of 117  (2) All record entries must be dated; (3) All records must reflect the primary language spoken by the Medicaid Beneficiary and any translation needs of the Medicaid Beneficiary; (4) All records must identify Medicaid Beneficiaries needing communication assistance in the delivery of Transportation