HomeMy WebLinkAboutContract 63578CSC No. 63578
CITY OF FORT WORT11I
ASSIGNMIrNT
Effective July 1, 2025, for value received, Metropolitan Area EMS Authority d/b/a
MedStar Mobile Healthcare ("Assignor") hereby assigns to the City of Fort Worth ("Assignee")
all of its right, title, and interest in and to that certain Collection Services Agreement dated
February 3, 2017, between Assignor and Credit Management Company formally known as
Nationwide Recovery Systems (the "Contract"), including all rights to receive services and all
obligations to pay fees or perform duties thereunder. Assignee hereby agrees to assume and
perform all duties and obligations of Assignor under the Contract from and after the effective
date.
This Assignment constitutes the entire agreement between Assignor and Assignee with
respect to the subject matter hereof. No modification of any provision of this Assignment shall
be effective unless in writing and signed by Assignor and Assignee. This Assignment shall inure
to the benefit of and be binding upon Assignor and Assignee and their respective successors and
assigns. This Assignment shall be governed by the terms of the Contracts and the laws of the
State of Texas, without application of principles of conflicts of law.
This Assignment may be executed in one or more counterparts each of which shall be
deemed an original but all of which together shall constitute one and the same instrument.
Signed signature pages may be transmitted by facsimile or e-mail, and any such signature shall
have the same legal effect as an original.
Dated the day of _ v 2025.
Metropolitan Area EMS Authority dba MedStar
Mobile Healthcare
(Assignor)
By. i
Print: Fra ;esh /
Title: Interim Chief Executive Officer
City of Fort Worth
(Assignee)
Print: Jesus Chapa
Title: City Manager
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page 1 of
NOTARY ACKNOWLEDGEMENT
On the day of _l'. T 2025, personally appeared
who acknowledged to me that (s)he is the Interim Chief Executive Officer
of Metropolitan Area EMS Authority dba MedStar Mobile Healthcare ("Assignor"), and that
(s)he executed this document for the purposes and consideration contained herein.
Metropolitan Area EMS Au horit db dStar Mobile
Healthcare
By -- -
Print: Fran Gresh
Title: Interim Chief Executive Officer
SUBSCRIBED TO before me on this LOA- day of ��yje. 2025.
IF
•�Y'rs'' MONICACRUZ
•A '''s My Notary ID # 126504816 Notary Public in and fort ` St of
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°•',ra,oF�',• Expires May 20, 2028 My commission Expires:(
NOTARY ACKNOWLEDGEMENT
On the Z1 day of SQv\4?_ _ 2025, personally appeared
'3esys C,"O , who acknowledged to me that (s)he is the City Manager of
-. __.
City of Fort Worth ("Assignee"), and that (s)he executed this document for the purposes and
consideration contained herein.
City of Fort I
By:�
Print: Jesus Chapa
Title: City Manager
SUBSCRIBED TO before me on this 2_1�`- day of _ ��n _ 2025.
Victoria Esquivet
My Commission Expires N tary ublic in and for the State of a,3
FNotary
5/12/2029
ID135515177 M tnmission Expires: SI_i2/_2o29_____.
Assigrnnent Page 2 of 3
CONSENT TO ASSIGNMENT
Effective July 1, 2025, Credit Management Company formally known as Nationwide
Recovery Systems hereby consents to the assignment by Metropolitan Area EMS Authority d/b/a
MedStar Mobile Healthcare ("Assignor") to the City of Fort Worth ("Assignee") of all of
Assignor's rights and obligations under that certain Collection Services Agreement dated
February 3, 2017 (the "Agreement"), including the right to receive services and the obligation to
perform and pay for all duties as set forth in the Agreement. This consent is conditioned upon
Assignee's continued compliance with all terms and conditions of the Agreement applicable to
Assignor.
Credi Mat
By:
Name:_
Title: 1
Date:
Assignment Page 3 of 3
NATIONWIDE RECOVERY SYSTEMS
COLLECTION SERVICES AGREEMENT
THIS AGREEMENT for collection services ("Agreement') is made and entered into the , J X0 day of February 2017
between Nationwide Recovery Systems, with its principal place of business located at 501 Shelley Drive, Suite
300 in Tyler, Texas 75701 ("AGENCY"), and the Metropolitan Area EMS Authority, d.b.a. MedStar Mobile
Healthcare, located at 2900 Alta Mere Drive, Fort Worth, Texas 76116 ("CLIENT").
I . AGENCY will devote its best efforts to collect and recover the full amount due on accounts placed with
AGENCY by CLIENT for collection, through persistent and diligent activity, which shall at all times be legal
and ethical and in compliance with State and Federal rules and regulations and which shall, insofar as is
practical, maintain the debtor's goodwill toward CLIENT. AGENCY agrees to keep all information
pertaining to the accounts and debtors strictly confidential at all times, including after the termination of this
Agreement.
2. Accounts shall be forwarded electronically to AGENCY. CLIENT will furnish records showing the total
amount of the unpaid balance on each account, date of sale or service, and other pertinent information.
AGENCY shall be responsible for all expenses incurred by CLIENT to establish an electronic file transfer
process, including any required software programming.
3. CLIENT will not refer any account to AGENCY with a balance due of less than $25.00.
4. AGENCY shall not forward or assign accounts to other agencies for collection or to attorneys for legal action
without prior written consent from CLIENT, Such secondary placement shall not relieve AGENCY of its
obligations under this Agreement nor create an agreement between CLIENT and third parry agencies or
attorneys.
5. AGENCY has the discretion and authority to agree to delayed payment schedules or installment payments
from account debtors. AGENCY also has the discretion to compromise accounts, subject to a maximum
discount of 20%. Any settlement for less than 80% of the amount due cannot be accepted by AGENCY
without prior written authorization from CLIENT.
6. AGENCY will provide the following to CLIENT:
• MONTHLY REPORT OF ALL ACOUNTS PLACED WITH AGENCY
• BI-MONTHLY REPORT OF REMITTANCES RECEIVED BY AGENCY
• RETURN LIST[NGS—AS ACCOUNTS ARE CLOSED
• MONTHLY LISTING OF ALL ACCOUNTS ON HOLD
• DEBTOR INVENTORIES --ON DEMAND
• CLIENT ACCOUNTING REMITTANCES
• DIRECT COMPUTER INTERFACING
• MONTHLY REPORT OF ACCOUNTS NEWLY REPORTED TO CREDIT AGENCIES AND
CHANGES TO OR WITHDRAWALS OF REPORTS
7. AGENCY shall remit to CLIENT all funds collected on CLIENT's accounts funds prior to the 15th day of the
month following receipt of payment. AGENCY shall submit monthly billing statements giving the debtor's
name, account number, amount collected on the account, AGENCY commission, date of service, and
placement date. AGENCY will be paid its commission approximately 30 days from the date on the
statement.
8. CLIENT agrees to provide AGENCY with a report of all direct payments received by CLIENT on accounts
currently placed for collection with AGENCY by the I Oth day of the month after the payments are received.
AGENCY shall include these payments on its monthly commission invoice.
9. In cases where insurance is identified after placement, the account will be placed on hold by AGENCY while
CLIENT attempts to collect from the insurer. If there is a remaining balance after CLIENT has attempted to
collect from the insurer, CLIENT will notify AGENCY of the remaining balance, if any, and AGENCY will
resume collection efforts.
10. As consideration for the AGENCY's collection services hereunder, CLIENT shall pay AGENCY a
commission of sixteen percent (16%) for primary placement accounts. Should CLIENT request AGENCY's
servicing on secondary placement accounts, the commission paid AGENCY will be thirty-five percent (35%).
9. For accounts where the CLIENT's services were provided to the account debtor in connection with a Motor
Vehicle Accident (MVA), the commission shall be ten percent (101/6). Such accounts will be identified as
"MVA" upon placement with AGENCY and in AGENCY's monthly invoices.
10. AGENCY will not report accounts to the credit bureaus until forty-five (45) days after placement.
11. AGENCY shall return accounts not collected in full within 180 days of the date of placement, The 180 day
period will not run during the time that an account is on hold pending insurance processing or during the time
that a debtor is complying with a payment plan. AGENCY is not entitled to a commission on payments
received after an account has been returned to CLIENT under this paragraph 11.
12. From time to time, CLIENT may discover that an account debtor has Medicaid coverage after the account has
been placed for collection. When AGENCY receives written notice of Medicaid coverage from CLIENT,
AGENCY shall immediately cease collection efforts on the account and return it to CLIENT. When
AGENCY receives notice of Medicaid coverage from the account debtor or from Medicaid, AGENCY shalt
immediately cease collection efforts and notify CLIENT in writing and return the account to CLIENT.
AGENCY shall not be entitled to any commission on payments received from Medicaid. AGENCY shall
refund to CLIENT any commissions previously collected from debtors who are determined to be Medicaid
eligible.
13. CLIENT may withdraw any account(s) from placement with AGENCY upon written notice but AGENCY
shall be entitled to a commission on payments received by AGENCY on the account(s) within thirty (30) days
of the notice of withdrawal, except as provided in paragraph 11.
14. AGENCY agrees to deposit all funds received by AGENCY as payment on CLIENTS accounts under this
agreement into an AGENCY Trust Account.
15. AGENCY will execute the Health Insurance Portability and Accountability Act (HFAA) Business Associate
Agreement that is attached as Exhibit A, which is expressly incorporated herein.
16. The term of this Agreement is three years, which will commence upon execution by both parties. The parties
may extend the Agreement for additional one year terms upon written agreement. Either party may terminate
this Agreement by giving 30 days written notice to the other by registered or certified mail, return receipt
requested. Upon termination by notice, all accounts will be returned to CLIENT on or before the effective
date. If the Agreement terminates by expiration, all accounts must be returned to CLIENT within 30 days
after expiration of the Agreement. Following termination, Agency shall only be entitled to a commission on
payments received by AGENCY within 30 days of termination. All subsequent payments received by
AGENCY must be forwarded to CLIENT and CLIENT will pay any commission due.
17. AGENCY shall maintain individual records on each account, including: the date the account was referred to
AGENCY; the amount referred to AGENCY for collection; any amount added as an attorney's fee; a record
of each action taken by AGENCY; the amount of each payment on the account; and the balance due on the
accounts. If legal action is filed, AGENCY shall also record and report the attorney's fees and expenses and
report the date of filing, name of court, disposition, date and amount of judgment, and if any execution is
issued.
This agreement sets forth the fill terms and conditions of the agreement between the parties and no
modification thereof addition thereto shall be effective unless contained in writing, signed by both parties.
IN WITNESS WHEREOF, the parties hereto have executed this agreement.
Dated:
CLIENT:
Area Metropolitan Ambulance Authority
d.b.a. MedStar Mobile Healthcare
gyr
Doueslooten, O
AGENCY:
Nationwide Recove Systems
Bill Giovanni iusiness Development
BUSINESS ASSOCIATE AGREEMENT
This Business Associate Agreement (this "Agreement") is entered into by and between
Nationwide Recovery Systems ("Business Associate") and Metropolitan Area EMS Authority
DBA MedSter Mobile Healthcare ("Covered Entity") and dated effective 3 A-D of February
(the "Effective Date").
RECITALS
A. Covered Entity is a health care provider. The U.S. Department of Health and Human Services
has issued final regulations on Standards for Privacy of Individually Identifiable Health
Information (the "Privacy Rule") at 45 C.F.R. Parts 160 and 164 pursuant to the Health
Insurance Portability and Accountability Act of 1996 ("HIPAA"), governing the privacy of
Individually Identifiable Health Information obtained, created or maintained by certain
entities, including health care providers.
B. Business Associate either 1) performs certain functions for, or on behalf of, Covered Entity
involving the disclosure of Protected Health Information ("PHI") by Covered Entity to
Business Associate, or the creation or receipt of PHI by Business Associate on behalf of
Covered Entity; or 2) provides legal, actuarial, accounting, consulting, data aggregation,
management, accreditation, administrative or financial services for Covered Entity involving
the disclosure of Protected Health Information ("PHI") by Covered Entity or another business
associate of Covered Entity.
C. Covered Entity is required by HIPAA to obtain satisfactory assurances that Business
Associate will appropriately safeguard all PHI disclosed by, or created or received by
Business Associate on behalf of Covered Entity,
D. The parties desire to enter into this Agreement to protect PHI, and to amend any agreements
between them, whether oral or written, with the execution of this Agreement.
NOW, THEREFORE, FOR AND IN CONSIDERATION OF the representations, warranties and
covenants contained herein, and other good and valuable consideration, the receipt and
sufficiency of which is hereby acknowledged, the parties hereto agree as follows:
1. Effect. This Agreement supplements, modifies and amends any and all agreements, whether
oral or written, between the parties involving the disclosure of PHI by Covered Entity to
Business Associate, or the creation or receipt of PHI by Business Associate on behalf of
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V2.1_081313
Covered Entity. The terms and provisions of this Agreement shall supersede any other conflicting
or inconsistent terms and provisions in any other agreements between the parties, including all
exhibits or other attachments thereto and all documents incorporated therein by reference.
Without limitation of the foregoing, any limitation or exclusion of damages provisions shall not
be applicable to this Agreement.
2. Terms Used. Terms used herein without definition shall have the some meaning ascribed to
them in 45 C.F.R. Parts 160 and 164.
3. Permitted Uses and Disclosures of Protected Health Information. Except as otherwise
limited in this Agreement, Business Associate may use and disclose PHI to perform functions,
activities, or services for or on behalf of Covered Entity provided that such use or disclosure
would not violate the Privacy Rule if done by Covered Entity. All other uses not authorized by
the Agreement are prohibited.
4. Resnonsibilities of Business Associate with Respect to Protected Health Information.
Willi regard to the use and disclosure of PHI, Business Associate hereby agrees to do the
following:
a. to use and disclose PHI only as permitted or required by this Agreement or as Required By
Law.
b. to use appropriate safeguards to prevent the use and disclosure of PHI other than as provided
for by this Agreement.
c, to report to Covered Entity any use or disclosure of PHI that is not provided for by this
Agreement.
d. to ensure that all agents, including subcontractors, to whom it provides PHI received from, or
created or received by, Business Associate on behalf of Covered Entity agree to the same
restrictions and conditions on the use and disclosure of PHI that apply to Business Associate
pursuant to this Agreement with respect to such information.
e, to provide access (at the request of, and in the time and manner designated by, Covered Entity)
to PHI in a Designated Record Set to Covered Entity or, as directed by Covered Entity, to an
Individual in order to meet the requirements under 45 C.F.R.
164,524, This provision shall be applicable only if Business Associate has PHI in a Designated
Record Set.
f. to make any amertdment(s) (at the request of, and in the time and manner designated by,
Covered Entity) to PHI in a Designated Record Set that Covered Entity directs or agrees to
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pursuant to 45 C.F.R. 164.526. This provision shall be applicable only if Business Associate has
PHI in a Designated Record Set.
g. to make internal practices, books, and records relating to the use and disclosure of PHI
received from, or created or received by, Business Associate on behalf of Covered Entity
available to Covered Entity, or at the request of Covered Entity, to the Secretary of the
Department of Health and Human Services or his / her designee (the "Secretary"), in a time and
manner designated by Covered Entity or the Secretary, for purposes of the Secretary determining
Covered Entity's or Business Associate's compliance with the Privacy Rule.
h. to document such disclosures of PHI and information related to such disclosures as would be
required for Covered Entity to respond to a request by an Individual for an accounting of
disclosures of PHI in accordance with 45 C.F.R. 164.529.
i, to provide to Covered Entity, in a time and manner agreed upon by the parties, information
collected in accordance with Section 3(h) of this Agreement, to permit Covered Entity to respond
to a request by an individual for an accounting of disclosures of Protected Health Information in
accordance with 45 C.F.R. 164.528.
5. Resoonsibilities of Covered Entitv with Resneet to Protected Health Information. If
deemed applicable by Covered Entity, Covered Entity shall:
a. provide Business Associate with the notice of privacy practices that Covered Entity produces
in accordance with 45 C.F.R. 164.520 as well as any changes to such notice,
b. provide Business Associate with any changes in, or revocation of, permission by Individual to
the use or disclosure of PHI, if such changes affect Business Associate's permitted or required
uses or disclosures.
c. notify Business Associate of any restriction to the use or disclosure of PHI that Covered Entity
has agreed to in accordance with 45 C.F.R. 164.522.
6. Specific Use and Disclosure by Business Associate. Except as otherwise limited in this
Agreement, Business Associate may:
a. use PHI for the proper management and administration of Business Associate or to carry out
the legal responsibilities of Business Associate.
b. disclose PHI for the proper management and administration of Business Associate, provided
that the disclosures are Required by Law, or Business Associate obtains reasonable assurances
from the person to whom PHI is disclosed that it will remain confidential and used or further
disclosed only as Required by Law or for the purpose for which it was disclosed to the person,
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w_�. V2.1_081313
Mfl9Jt i tis:'tt Ti+�,i,r�
and the person notifies the Business Associate of any instances of which it is aware in which the
confidentiality of PHI has been breached,
c, use PHI to provide Data Aggregation services to Covered Entity as permitted by 45
C.F.R. 164.504(e) (2)(i)(B).
d. use PHI to report violations of law to appropriate federal and state authorities, consistent with
45 C.F.R. 164.5020)(1).
7. Term and Termination.
a. Term. The Term of this Agreement shall be effective as of the Effective Date and shall
terminate when all of the PHI provided by Covered Entity to Business Associate, or created or
received by Business Associate on behalf of Covered Entity, is destroyed or returned to Covered
Entity, or, if it is infeasible to return or destroy PHI, protections are extended to such PHI, in
accordance with Section 7(c) herein.
b. Termination for Cause. Covered Entity may terminate this Agreement if Covered Entity
determines that Business Associate has breached a material term of this Agreement; provided.
however, that Business Associate shall have the opportunity to cure the breach or end the
violation within thirty (30) days of receipt of Covered Entity's notice of breach and this
Agreement shall not terminate if Business Associate cures the breach or ends the violation within
such thirty (30) day period.
c. Effect of Termination.
(1) Except as provided in subparagraph (2) of this Section 7 (c), upon termination of this
Agreement, for any reason, Business Associate shall return or destroy all PHI received from
Covered Entity, or created or received by Business Associate on behalf of Covered Entity. This
Section 7(c) (1) shall apply to PHI that is in the possession of subcontractors or agents of
Business Associate. Business Associate shall retain no copies of the PHI,
(2) In the event that Business Associate determines that returning or destroying the PHI is
infeasible, Business Associate shall provide in writing to Covered Entity notification of the
conditions that make return or destruction infeasible. Upon mutual written agreement of the
parties that return or destruction of PHI is infeasible; Business Associate shall extend the
protections of this Agreement to such PHI and limit further uses and disclosures of such PHI to
those purposes that make the return or destruction infeasible, for so long as Business Associate
maintains such PHI.
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8. Miscellaneous.
a. Amendment. The Parties agree to take such action as is necessary to amend this Agreement
from time to time as is necessary for Covered Entity to comply with the requirements of the
Privacy Rule and HIPAA.
b. Survival. The respective rights and obligations of Business Associate under Section 7(c) shall
survive the termination of this Agreement.
c. Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a meaning that
permits Covered Entity to comply with the Privacy Rule.
d. No Third Party Beneficiary. Nothing in this Agreement is intended, nor shall be deemed, to
confer any benefits on any third party.
COVERED ENTITY:
METROPOLITAN AREA EMS AUTHORITY
DBA: MEDSTAR MOBILE HEALTHCARE
By:/ca, •�
Name: I o s R. Hootfn
Title: CEO
BUSINESS ASSOCIATE:
Nationwide Recovery Syste s
By: x .
Name: Bill (ovannCevelopment
Title: VP Business
Page 5 _ -. _ _ .- _._.
ACCEPTED AND AGREED:
CITY OF FORT WORTH:
By: Jay Chapa (Jul 2, 2025 09:49 CDT)
Name: Jesus "Jay" Chapa
Title: City Manager
Date:
APPROVAL RECOMMENDED:
/k—
By. Reginald Zeno (Jul 2, 2025 08:11 CDT)
Name: Reginald Zeno
Title: FMS Director/CFO
ATTEST: o
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By: C
Name: Jannette S. Goodall
Title: City Secretary
CONTRACT COMPLIANCE MANAGER:
By signing, I acknowledge that I am the person
responsible for the monitoring and administration
of this contract, including ensuring all
performance and reporting requirements.
By: Odelle Carrette (Jul 1, 202513:19 CDT)
Name: Odelle Carrette
Title: Financial Services Manager, FMS
I:179ZI]%2ID MV111I01131dKlel7QDIKIQY619
B:
Y
Name: Taylor C. Paris
Title: Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX