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

Local Coordinating Board (LCB) concerning issues related to the provision of Non-Emergency Transportation Services to Medicaid Beneficiaries only. b. Refer to Attachment 4 for a template 2. Annual Financial Audit a. The STP shall conduct an annual financial audit in accordance with federal and State law, including; but not limited to, OMB Circular A~ 133 and Section 215.97, F.S., Florida Single Source Audit Act. The goal of the audit is to capture the STP's financial information in a format for use by the Commission, its Agents, and federal and State auditors. The STP shall submit the audit annually, along with a copy of the STP's Certification by hardcopy or in electronic format to the Commission. The STP shall limit the scope of the audit report it submits to the Commission to Transportation Services provided to Medicaid Beneficiaries. If, at any time, the Recipient is determined to be a Vendor for purposes of OMB Circular A-133 and/or the Florida Single Source Act, the Recipient shall still be required to submit an annual financial audit in accordance with the proviSions of OMB Circular A-133 and/or the Florida Single Source Act. b. The Commission does not provide a template for this report. Refer to Attachment 2 for details on Special Audit Requirements. 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 81 of 117  3. Trip Travel Expense Report a. The purpose of this report is to track the travel expenses incurred by the STP for each Trip that incurs travel expenses, as set forth in the Covered Services Section of this Contract. b. Refer to Attachment 5 for a template. 4. Safety Compliance Self Certification Report a. Self Certification - Each STP/Transportation· Provider shall submit an annual safety and security Certification, in accordance with 14-90.10, F.A.C., to the Commission, and shall submit to any and all Safety and Security Inspections and Reviews in accordance with 14-90.12, F.A.C. Each STP/Transportation Provider shall submit the total number of vehicle inspections completed during the previous calendar year (January 1 through December 31) and the results of said inspections by January 15th of each year. b. The· Safety Compliance Self Certification Report shall include, at a minimum, a certification that the STP/Transportation Provider has instituted and are complying with the following safety and monitoring procedures: (1) Vehicle safety inspection; (2) Drug and alcohol training and monitoring; (3) Quarterly monitoring; and, (4) Operator/driver training and monitoring. c. The Commission does not provide a template for this report. 5. Systems Outage Notification Report a. The STP shall notify the Commission Project Manager by electronic submission or by telephone of a System outage immediately upon determination of a System outage. b. The STP shall submit the Business Disruption Notification using the template provided as a guideline. The Business Disruption Notification shall provide the date and time the incident occurred, what event triggered the outage, the plan of action to bring the System back online, 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 82 of 117  the expected date and time of recovery of the full use of the System, and the impact the System outage has on Medicaid Beneficiaries. c. The STP must submit a Systems Outage Report, in electronic format and hardcopy, to the Commission's Project Manager only if the STP's Information Systems experience unscheduled downtime. d. Refer to Report #6 for template. 6. Suspected Fraud Reporting a. Upon detection of a potential or suspected Fraudulent encounter or act by a Medicaid Beneficiary, the STP shall file a report with the Commission. The Commission will forward the report to the AHCA's Bureau of Medicaid Program Integrity. b. The report shall contain at a minimum: (1) The name of the Medicaid Beneficiary; (2) The Medicaid Beneficiary's Medicaid identification number; and (3) A description of the suspected Fraudulent act. c. The Commission does not provide a template for this report. 7. Critical Incident Reporting a. The STP shall notify the Commission within one (1) Business Day that there was a critical incident. b. The critical Incident reporting requirements set forth in this Section do not replace the abuse, Neglect, and exploitation reporting system established by the State. c. The definitions of reportable critical incidents are as follows: (1) Death of a Medicaid Beneficiary that occurs while the Medicaid Beneficiary is in a vehicle operated or contracted by the STP, due to one (1) of the followi ng: . (i) Suicide; (ii) Homicide; (iii) Abuse; (iv) Neglect; or, 2008/2009 Medicaid Non-Emergenc.y Transportation Subcontracted Transportation Provider Contract Page 83 of 117  (v) An accident or other incident. (2) Medicaid Beneficiary Injury or Illness - A medical condition that requires medical treatment by a Health Care Professional and which is sustained, or allegedly is sustained, due to an accident, act of Abuse, Neglect or other incident occurring while a Medicaid Beneficiary is in a vehicle operated or contracted by the STP. (3) Sexual Battery - An allegation of sexual battery, as determined by medical evidence or law enforcement involvement, by: (i) A Medicaid Beneficiary on another Medicaid Beneficiary; (ii) An employee of the STP, a Subcontractor, or a Transportation Provider on a Medicaid Beneficiary; and/or, (iii) A Medicaid Beneficiary on an employee of the STP, a Subcontractor, or a Transportation Provider. (4). In addition to supplying the Critical Incidents Report, the STP shall also report critical incidents in the manner prescribed by, and using the template provided by, the appropriate district's DCF Alcohol, Drug Abuse Mental Health office, using the appropriate DCF reporting forms and procedures. (5) Refer to Report #7 for a template. 8. Minority PartiCipation Report 1. The Commission encourages the STP to use Minority and Certified Minority businesses as subcontractors when procuring commodities or services to meet the requirement of the Agreement. The Commission requires information regarding the STP's use of minority owned businesses as subcontractors for transportation services under this Agreement. This information will be used for assessment and evaluation of the Commission's Minority Business Utilization Plan. During the term of the Agreement,it will be necessary for the STP to maintain this information monthly. A minority owned business is defined as any business enterprise owned and operated by the following ethnic groups: African American (Certified Minority Code H or Non-Certified Minority Code N), Hispanic American (Certified Minority Code I or Non-Certified Minority 0), Asian American (Certified Minority Code J or Non-Certified Minority Code P), Native American (Certified Minority Code K or Non- Certified Minority Code Q), or American Woman (Certified Minority Code M or Non-Certified Minority Code R). The STP should retain this information and make it available upon request by the Commission. 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 84 of 117  XI METHOD OF PAYMENT A. Fixed Price Rxed Fee Agreement 1. This is a fixed price (fixed fee) Agreement. The Commission shall pay the STP, upon satisfactory completion of all terms and conditions specified in the Agreement, a total amount included in Exhibit B. 2. The STP shall request payment through submission of a properly completed invoice to the Commission. Invoices shall be submitted in a format provided by the Commission. 3. The Commission's performance and obligation to pay under this Agreement is contingent upon an annual appropriation by the Legislature. 4. Transportation Services are mandatory Medicaid services that shall not be restricted due to inadequate funding. Through this Contract, the STP accepts the responsibility to provide or coordinate delivery of all Transportation Services within the existing funds of this Contract.