HomeMy WebLinkAboutContract 46373 CITYSECR UAW
PROFESSIONAL SERVICES AGREEMENT
OFFICIAL RECORD
CITY SECRETARY
1. AGREEMENT BETWEEN PARTIES � °WORTH,TX
This PROFESSIONAL SERVICES AGREEMENT ("Agreement") is made and entered into
by and between the CITY OF FORT WORTH (the "CITY"), a home rule municipal
corporation of the State of Texas, acting by and through Susan Alanis, its duly authorized
Assistant City Manager, and NOVA HEALTHCARE, P.A. (the "PROVIDER"), acting by
and through Bruce Meymand, its duly authorized Chief Operating Officer.
2. GENERAL
2.1 PROVIDER hereby agrees to provide the CITY, in accordance with medically necessary
or appropriate professional standards, a full range of occupational injury medical
treatment and health care services, as outlined in Exhibits "A" and `B," including any
attachments thereto, both of which are hereby made part of this Agreement for all
purposes. In the event there is any conflict between the provisions and conditions of the
exhibits and the provisions and conditions set forth in the body of this Agreement, the
provisions and conditions set forth in the body of the Agreement shall control.
2.2 CITY and PROVIDER both recognize and acknowledge the professional nature of this
Agreement. Being cognizant that issues of interpretation and performance will inevitably
arise, both parties agree to consult with each other and covenant to negotiate in the
utmost good faith in order to ensure performance of this Agreement without hindrance.
2.3 Services under this Agreement will be provided at PROVIDER's current facilities, at a
subcontractor's facilities (if the subcontractor and the facilities are approved in writing by
the CITY prior to such services being provided), and at such CITY facilities and other
locations as may be mutually agreed to in writing by PROVIDER and CITY.
2.4 Both parties recognize the non-exclusive nature of this Agreement and acknowledge and
agree that CITY is free to engage persons other than PROVIDER to furnish injury-related
occupational health care and workers' compensation services compensable or defined
under the Texas Labor Code, as currently in effect or hereafter amended. PROVIDER
further acknowledges that the CITY has elected to contract with multiple vendors
as preferred providers of occupational injury medical treatment and health care
services.
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2.5 PROVIDER is not authorized to furnish non-injury occupational health care services
under the terms of this Agreement, and CITY shall bear no responsibility for
compensating PROVIDER for any such services.
3. AGREEMENT TERM
3.1 The initial term of this Agreement shall commence on January 1, 2015 ("Effective
Date") and shall expire on December 31, 2017, unless terminated earlier in
accordance with the provisions of this Agreement.
3.2 CITY shall have the sole right to renew this Agreement for two additional 1-year
terms. If CITY desires to exercise an option to renew, CITY shall notify PROVIDER
in writing of its intention to renew at least 60 days prior to the end of the then-current
term. Compensation to be paid during any option term shall be the same as that
provided for in the Initial Term.
4. INVOICING AND COMPENSATION
4.1 The Parties agree the Schedule for Compensation as shown in the attached Exhibit
"B" is acceptable as the compensation to be paid to PROVIDER for specified medical
treatment and care provided to CITY employees during the initial contract period and
the subsequent option periods, if exercised by the CITY. The parties acknowledge
that additional services provided by PROVIDER to the CITY may become desirable
and agree to conduct negotiations on such additional services in good faith to arrive at
mutually agreeable terms for such additional services with respect to performance and
compensation. Any additional services will be reflected by a separate agreement or
by a written amendment to this Agreement signed by the parties.
4.2 Billing of all medical services related to a compensable on-the-job injury will be
submitted directly to the CITY's contractor / third party administrator ("TPA") for
workers' compensation claims in accordance with the Texas Labor Code and related
administrative rules, as outlined in Exhibit"B."
4.3 For any alleged on-the-job injury that the TPA determines is not a compensable
injury, CITY agrees to pay, through its TPA, for initial and follow-up office visits
(including medical treatments provided during those visits) that occur prior to the
TPA's determination.
4.5 For any alleged on-the-job injury that the TPA determines is a compensable injury,
the CITY, through its TPA, shall pay for care and services that are related to the
compensable injury with the amount of such payments to be determined according to
reasonableness and medical necessity of the treatment or service, in accordance with
Texas Department of Insurance— Division of Workers' Compensation ("TDI-DWC"
or "DWC") treatment guidelines and DWC-approved medical fee schedules.
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4.6 Billing issues, including contests, disputes, and requests for additional
documentation, shall be handled in accordance with Section 408.027 of the Texas
Labor Code or its successor.
5. RECORDS AND RECORDS MANAGEMENT
5.1 PROVIDER will adhere to and follow the governing guidelines as they pertain to the
protection and use of collected data (personal/rnedical information). CITY may, to
the extent permissible under applicable law, obtain copies of such records solely for
its internal purposes and agrees to reimburse PROVIDER for the cost of such copies
at the rate published in the Texas Administrative Code in effect as of the time
copying is performed.
5.2 Upon termination or expiration of this Agreement, PROVIDER agrees to return to the
CITY, or its designated agent, all medical records delivered to PROVIDER on or
about the Effective Date (the "Pre-Existing Medical Records"). Upon receipt of
authorization from the affected CITY employees or their representatives for
PROVIDER to view and use the "Pre-Existing Medical Records" (which
authorization may be given at any time so long as it is in accordance with applicable
law concerning confidentiality of medical records), PROVIDER may keep copies
thereof at its sole copying expense, or may subsequently request copies thereof from
the CITY and shall reimburse the CITY at the rate published the Texas
Administrative Code in effect as of the time copying is performed.
5.3 It is recognized that additional medical records created by PROVIDER in the
performance of this Agreement, regardless of form or medium of storage ("New
Medical Records") shall be and remain the property of PROVIDER and shall not be
moved or transferred from PROVIDER except in accordance with applicable law and
PROVIDER's policies as set forth in this Agreement or as otherwise approved in
advance and in writing by the CITY. Before requesting New Medical Records from
PROVIDER, CITY shall obtain from CITY's employee (or that person's legal
representative) authorization to release copies of medical records in accordance with
applicable state and federal law concerning the confidentiality of medical records;
provided, however, that PROVIDER agrees to use all reasonable efforts to obtain the
written consent of each patient seen by PROVIDER under this Agreement
authorizing PROVIDER to release copies of such "New Medical Records" to the
CITY upon its request therefor. Upon expiration or termination of this Agreement,
PROVIDER shall retain the originals of all "New Medical Records" in its possession,
and CITY shall, to the extent permissible by applicable law, have the right to receive
copies. CITY agrees to reimburse PROVIDER for the cost of such copies at the rate
published in the Texas Administrative Code in effect as of the time copying is
performed.
5.4 PROVIDER agrees that no medical records covered by the terms of this Agreement
will be altered or destroyed unless (i) the CITY has provided express written
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authorization and (ii) destruction of such records is otherwise permitted under
applicable law. CITY recognizes that medical records will, from time to time, cease
to have administrative, financial, and/or legal value to either CITY or PROVIDER
and CITY and PROVIDER agree to utilize appropriate records retention and
destruction schedules for the purpose of lawful and efficient records management.
5.5 PROVIDER will exercise appropriate care to preserve necessary and useful medical
records generated during the term of this Agreement. PROVIDER will timely notify
and solicit CITY's input concerning any change or modification to any system or
process change involving the management, use, storage, and retention of medical
records generated during the term of this Agreement to allow the CITY to ascertain if
any issues or consequences, legal, financial, or practical, are reasonably foreseeable
because of the facility or systems modifications. CITY and PROVIDER agree to
negotiate in good faith to address any such issues and consequences in a manner
equitable to both parties and consistent with the purposes of this Agreement.
5.6 All reports and records provided to PROVIDER by the CITY shall remain the sole
property of the CITY. PROVIDER shall store and maintain such reports and records
separately from any other documents and in a manner and location that is easily
accessible to CITY staff members. The CITY, to the extent pennissible under
applicable law, shall have access to such reports and records during PROVIDER's
normal working hours and will provide PROVIDER with reasonable advance notice
of a need for access. PROVIDER shall treat as strictly confidential all reports and
records provided by the CITY and shall not release any such reports or records, or
any portion of their contents, to third parties without the CITY's advance written
consent. PROVIDER shall not copy or reproduce any such records or reports, unless
(i) the CITY has provided advance written consent and (ii) such reproduction is
otherwise permitted under applicable law. The CITY will provide a list of terminated
employees annually to PROVIDER. PROVIDER will separate records relating to
terminated employees from other records. The CITY may, to the extent permissible
under applicable law, retrieve original copies of all reports and records relating to
terminated employees from PROVIDER at any time.
6. MINORITY BUSINESS ENTERPRISE (MBE) PARTICIPATION
6.1 In accord with the CITY Code of Ordinances, the CITY has goals for the
participation of minority business enterprises in CITY agreements. PROVIDER
acknowledges the MBE goal established for this Agreement, as set forth below, and
its commitment to meet that goal. Any misrepresentation of facts (other than
negligent misrepresentation) and/or the commission of fraud by PROVIDER may
result in the termination of this Agreement and debarment from participating in CITY
contracts for a period of time of not less than three (3) years.
6.2 Because subcontracting opportunities for occupational injury medical treatment and
care services are negligible, no MBE goal has been set for this Agreement.
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7. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
("HIPAA")
7.1 Compliance
In the conduct of performing their obligations under this Agreement, the parties shall
comply in all material aspects with all applicable federal, state and local laws and
regulations, including, without limitation, the Health Insurance Portability and
Accountability Act of 1996, amendments thereto, and any associated administrative
regulations (collectively, "HIPAA"). Each Party agrees to abide by the policies and
procedures applicable to the relationship created hereunder for the privacy and
security of Protected Health Information; as such term is defined in HIPAA.
PROVIDER agrees not to use or further disclose Protected Health Information other
than as permitted or required by this Agreement or as required by law. PROVIDER
will assume the responsibility as a business associate in accordance with HIPAA on
behalf of the CITY as it relates to non-occupational injury care services. In addition,
PROVIDER shall:
7.1.1 Use appropriate safeguards to prevent use or disclosure of the Protected Health
Information other than as provided for by this Agreement.
7.1.2 Mitigate, to the extent practicable, any harmful effect that is known to
PROVIDER of the use or disclosure of Protected Health Information by
PROVIDER in violation of the requirements of this Agreement.
7.1.3 Report to the CITY any use or disclosure of the Protected Health Infonnation
not provided for by this Agreement.
7.1.4 Ensure that any agent, including a subcontractor, to whom PROVIDER
provides Protected Health Information received from, or created or received by
PROVIDER on behalf of the CITY, agrees to the same restrictions and
conditions that apply through this Agreement to PROVIDER with respect to
such information.
7.1.5 Make internal practices, books, and records, including policies and procedures
and Protected Health Information received from, or created or received by
PROVIDER on behalf of the CITY available to the Secretary of the Department
of Health and Human Services or his or her designee ("Secretary"), in a time
and manner designated by the Secretary to determine PROVIDER compliance
with HIPAA.
7.1.6 Provide access, at the request of the CITY, and in the time and manner
designated by the CITY, to Protected Health Information in a Designated
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Record Set, to the CITY or, as directed by the CITY, to an individual in order to
meet the requirements under 45 CFR 164.524.
7.1.7 Make any amendment(s) to Protected Health Information in a Designated
Record Set that the CITY directs or agrees to pursuant to 45 CFR 164.526 at the
request of the CITY or an individual, and in the time and manner designated by
the CITY.
7.1.8 Document such disclosures of Protected Health Information and information
related to such disclosures as would be required for the CITY to respond to a
request by an individual for an accounting of disclosures of Protected Health
Information in accordance with 45 CFR 164.528.
7.1.9 Provide to the CITY or an individual, in time and manner designated by the
CITY, information collected in accordance with Section 5 of this Agreement, to
permit the CITY to respond to a request by an individual for an accounting of
disclosures of Protected Health Infonnation in accordance with 45 CFR
164.528.
7.1.10 Consistent with HIPAA requirements, report to appropriate federal and state
authorities violations of law relating to Protected Health Information.
7.2 Permitted Uses and Disclosures by PROVIDER
Except as otherwise limited in this Agreement, PROVIDER may use or disclose
Protected Health Information on behalf of, or to provide services to, the CITY for the
proper management and administration by PROVIDER or to carry out the legal
responsibilities of PROVIDER.
7.3 Obligations of the CITY
The CITY shall inform PROVIDER of Privacy Practices and Restrictions by:
7.3.1 Providing PROVIDER with the notice of privacy practices that the CITY
produces for Occupational Health and Safety.
7.3.2 Providing PROVIDER with any changes in, or revocation of, permission by an
individual to use or disclose Protected Health Information, if such changes
affect PROVIDER's permitted or required uses and disclosures.
7.3.3 Providing notification to PROVIDER of any restriction to the use or disclosure
of Protected Health Information that the CITY has agreed to in accordance with
45 CFR 164.522.
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7.4 Termination for material breach of HIPAA by PROVIDER
Upon the CITY's knowledge of a material breach by PROVIDER the CITY shall
either:
7.4.1 Provide an opportunity for PROVIDER to cure the breach or end the violation
and terminate the Agreement if PROVIDER does not cure the breach or end the
violation, within the time specified by the CITY;
7.4.2 Immediately terminate this Agreement if PROVIDER has breached a material
term of the HIPAA requirements of this Agreement and a cure is not possible;
or
7.4.3 If neither termination nor cure is feasible, report the violation to the Secretary.
7.5 Effect of Termination
7.5.1 Except as provided in Section 5, upon termination of this Agreement, for any
reason, PROVIDER shall return or destroy all Protected Health Information
received from the CITY, or created or received by PROVIDER on behalf of the
CITY. This Provision shall also apply to Protected Health Information that is in
the possession of subcontractors or agents of PROVIDER. PROVIDER shall
retain no copies of the Protected Health Information as described in this
paragraph. CITY acknowledges that PROVIDER is required by state and
federal law to maintain medical records for a period of seven (7) years.
7.5.2 In the event that PROVIDER determines that returning or destroying the
Protected Health Information is infeasible, PROVIDER shall provide to the
CITY notification of the conditions that make return or destruction infeasible.
Upon the CITY's determination that return or destruction of the Protected
Health Information is infeasible, PROVIDER shall extend the protections of this
Agreement to such Protected Health Information and limit further uses and
disclosures of such Protected Health Information to those purposes that make
the return or destruction infeasible, for so long as PROVIDER maintains such
Protected Health Information.
7.6 Miscellaneous
7.6.1 The Parties agree to take such action as is necessary to amend this Agreement
from time to time as is necessary for the CITY to comply with requirements of
HIPAA.
7.6.2 The respective rights and obligations of PROVIDER under Section 7.5 of this
Agreement shall survive the termination of this Agreement.
7.6.3 Any ambiguity in this Agreement shall be resolved to permit PROVIDER to
comply with the Privacy Rule of HIPAA.
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8. TERMINATION
8.1 Written Notice
The CITY or PROVIDER may tenninate this Agreement at any time, with or without
cause, by providing the other party with 60 days' written notice of termination. Upon
the receipt of any such notice, PROVIDER shall immediately discontinue all services
and work and the placing of all orders or the entering into contracts for all supplies,
assistance, facilities and materials in connection with the performance of this
Agreement and shall proceed to cancel promptly all existing contracts insofar as they
are chargeable to this Agreement.
8.2 Non-appropriation of Funds
In the event no funds or insufficient funds are appropriated by the CITY in any fiscal
period for any payments due hereunder, CITY will notify PROVIDER of such
occurrence and this Agreement shall terminate on the last day of the fiscal period for
which appropriations were received without penalty or expense to the CITY of any
kind whatsoever, except as to the portions of the payments herein agreed upon for
which funds shall have been appropriated.
8.3 Duties and Obligations of the Parties following Termination
In the event that this Agreement is terminated prior to the expiration of the then
current term, PROVIDER shall, to the extent permissible by applicable law, provide
the CITY with copies of all completed or partially completed documents prepared
under this Agreement. CITY agrees to reimburse PROVIDER for the cost of such
copies at the rate published in the Texas Administrative Code in effect as of the time
copying is performed. CITY shall pay PROVIDER for services actually rendered up
to the effective date of ternination and PROVIDER shall continue to provide the
CITY with services requested by the CITY and in accordance with this Agreement up
to the effective date of termination. If PROVIDER's treatment of a CITY employee
is commenced before the effective date of termination of this Agreement and
continues beyond that date, CITY shall continue to pay PROVIDER for medically
appropriate services necessary to complete such treatment in accordance with the
Texas Labor Code and Administrative Rules until such care is completed. The CITY
also shall pay PROVIDER for services actually performed in accordance herewith
prior to such termination, less such payments as have been previously made, in
accordance with a final statement submitted by PROVIDER documenting the
performance of such work.
9. DISCLOSURE OF CONFLICTS AND CONFIDENTIAL INFORMATION
PROVIDER hereby warrants to the CITY that PROVIDER has made full disclosure in
writing of any existing or potential conflicts of interest related to services to be performed
under this Agreement. In the event that any conflicts of interest arise after the Effective
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Date of this Agreement, PROVIDER hereby agrees immediately to make full disclosure to
the CITY in writing. PROVIDER, for itself and its officers, agents and employees, further
agrees that it shall treat all information provided to it by the CITY ("City Information") as
confidential and shall not disclose any such information to a third party without the prior
written approval of the CITY. PROVIDER shall store and maintain City Information in a
secure manner and shall not allow unauthorized users to access, modify, delete, or
otherwise corrupt City Information in any way. PROVIDER shall notify the CITY
immediately if the security or integrity of any City Information has been compromised or is
believed to have been compromised.
10. RIGHT TO AUDIT
10.1 PROVIDER agrees that the CITY shall, until the expiration of five (5) years after
final payment under this Agreement, have access to and the right to examine, to the
extent permissible by applicable law, at reasonable times any directly pertinent
books, documents, papers and records of PROVIDER involving transactions
relating to this Agreement at no additional cost to the CITY. PROVIDER agrees
that the CITY shall have access during normal working hours to all necessary
PROVIDER facilities and shall be provided adequate and appropriate work space in
order to conduct audits in compliance with the provisions of this section. The CITY
shall give PROVIDER reasonable advance notice of intended audits. PROVIDER
agrees to photocopy such documents as may requested by the CITY. CITY agrees
to reimburse PROVIDER for the cost of copies at the rate published in the Texas
Administrative Code in effect as of the time copying is performed.
10.2 PROVIDER further agrees to include in all its subcontractor agreements hereunder a
provision to the effect that the subcontractor agrees that the CITY shall, until
expiration of five (5) years after final payment of the subcontract, have access to and
the right to examine at reasonable times any directly pertinent books, documents,
papers and records of such subcontractor involving transactions related to the
subcontract, and further that CITY shall have access during normal working hours to
all subcontractor facilities and shall be provided adequate and appropriate work space
in order to conduct audits in compliance with the provisions of this paragraph. CITY
shall give subcontractor reasonable notice of intended audits. Subcontractor shall be
required to photocopy such documents as may be requested by the CITY. CITY
agrees to reimburse subcontractor for the cost of copies at the rate published in the
Texas Administrative Code in effect as of the time copying is performed.
11. INDEPENDENT CONTRACTOR
It is expressly understood and agreed that PROVIDER shall operate hereunder as an
independent contractor as to all rights and privileges granted herein, and not as agent,
representative or employee of the CITY. Subject to and in accordance with the conditions
and provisions of this Agreement, PROVIDER shall have the exclusive right to control
the details of its operations and activities and be solely responsible for the acts and
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omissions of its officers, agents, servants, employees, contractors and subcontractors.
PROVIDER acknowledges that the doctrine of respondeat superior shall not apply as
between the CITY, its officers, agents, servants and employees, and PROVIDER its
officers, agents, employees, servants, contractors and subcontractors. Nothing herein
shall be construed as the creation of a partnership or joint enterprise between CITY
and PROVIDER.
12. LIABILITY AND INDEMNIFICATION
12.1 PROVIDER SHALL BE LIABLE AND RESPONSIBLE FOR ANY AND ALL
PROPERTY LOSS, PROPERTY DAMAGE AND/OR PERSONAL INJURY
(INCLUDING DEATH) TO ANY AND ALL PERSONS, OF ANY HIND OR
CHARACTER, WHETHER REAL OR ASSERTED, TO THE EXTENT
CAUSED BY THE NEGLIGENT ACT(S) OR OMISSION(S),
MALFEASANCE OR INTENTIONAL MISCONDUCT OF PROVIDER, ITS
OFFICERS, AGENTS, SERVANTS, OR EMPLOYEES.
12.2 PROVIDER COVENANTS AND AGREES TO, AND DOES HEREBY,
INDEMNIFY, HOLD HARMLESS AND DEFEND THE CITY, ITS
OFFICERS, AGENTS, SERVANTS AND EMPLOYEES, FROM AND
AGAINST ANY AND ALL CLAIMS OR LAWSUITS FOR EITHER
PROPERTY DAMAGE OR LOSS (INCLUDING ALLEGED DAMAGE OR
LOSS TO PROVIDER'S BUSINESS AND ANY RESULTING LOST
PROFITS) AND/OR PERSONAL INJURY (INCLUDING DEATH) TO ANY
AND ALL PERSONS, OF ANY KIND OR CHARACTER, WHETHER REAL
OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THIS
AGREEMENT, TO THE EXTENT CAUSED BY THE NEGLIGENT ACTS
OR OMISSIONS OR MALFEASANCE OF PROVIDER, ITS OFFICERS,
AGENTS, SERVANTS, OR EMPLOYEES.
13. ASSIGNMENT AND SUBCONTRACTING
PROVIDER shall not assign or subcontract any of its duties, obligations or rights under this
Agreement without the express prior written consent of the CITY. If the CITY grants
consent to an assignment, the assignee shall execute a written agreement with the CITY
and PROVIDER under which the assignee agrees to be bound by the duties and obligations
of PROVIDER under this Agreement. PROVIDER and Assignee shall be jointly liable for
all obligations under this Agreement prior to the date of assignment. If the CITY grants
consent to a subcontract, the subcontractor shall execute a written agreement with
PROVIDER referencing this Agreement under which the subcontractor shall agree to be
bound by the duties and obligations of PROVIDER under this Agreement as such duties
and obligations may apply. PROVIDER shall provide the CITY with a fully executed copy
of any such subcontract. Any attempted assignment or delegation of PROVIDER shall be
wholly void and totally ineffective for all purposes unless made in conformity with this
section.
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14. INSURANCE
14.1 Prior to commencement of any work pursuant to this Agreement, PROVIDER shall
provide the CITY's Occupational Health and Safety Division and Risk Management
Division with certificate(s) of insurance documenting policies that are required to be
in effect throughout the term of this Agreement and any renewals thereof and that are
to provide minimum coverage limits in accordance with this section.
14.2 The CITY reserves the right to review the insurance requirements of this section
during the effective period of the Agreement and any extension or renewal hereof,
and to modify insurance coverage and limits when deemed necessary and prudent by
the CITY's Risk Manager based upon changes in statutory law, court decisions, or
circumstances surrounding this Agreement, but in no instance will the CITY allow
modification whereupon the CITY may incur increased risk.
14.3 PROVIDER's financial integrity is of interest to the CITY; therefore, subject to
PROVIDER's right to maintain reasonable deductibles, PROVIDER shall obtain and
maintain in full force and effect for the duration of the Agreement, and any extension
hereof, at PROVIDER's sole expense, insurance coverage written on an occurrence
basis, except Technology and Professional Liability, which may be written on a
claims-made basis. All insurance required under this Agreement must be written by a
company that is authorized and admitted to do business in the State of Texas and that
is rated A- VII or better by A.M. Best Company or similar rating acceptable to the
CITY. Coverage shall be written in the following types and amounts:
14.3.1 Workers' Compensation—Statutory
Employers' Liability- $500,000/ $500,000 /$500,000
14.3.2 Commercial General (Public) Liability Insurance to include the following
types of coverage: Premises/Operations, Independent Contractors,
Products/Completed Operations, Personal Injury, and Contractual Liability.
(Combined Single Limit for Bodily Injury and Property Damage
$1,000,000 per Occurrence and $2,000,000 Aggregate)
14.3.3 Automobile Liability for Owned/Leased Vehicles, Non-Owned Vehicles, and
Hired Vehicles
(Combined Single Limit for Bodily Injury and Property Damage
$1,000,000 per accident)
14.3.4 Commercial Umbrella - $1,000,000 per occurrence $1,000,000 Aggregate
14.3.5 Technology(Cyber) Liability- $1,000,000 per Claim, $1,000,000 Aggregate
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14.3.6 Medical Professional Liability - $1,000,000 per medical incident and
$3,000,000 Aggregate
14.4 For coverage underwritten on a claims-made basis, the retroactive date shall be
coincident with or prior to the Effective Date of the Agreement and the certificate of
insurance shall state the coverage is claims-made and indicate the retroactive date.
14.5 All required insurance shall be maintained for the duration of the Agreement and for
five (5) years following completion of the service provided under the Agreement. An
annual certificate of insurance submitted to the CITY shall evidence such insurance
coverage.
14.6 PROVIDER additionally warrants that any physician providing health care to CITY
employees shall have Medical Malpractice coverage with minimum limits of
$200,000 per medical incident, with a$600,000 aggregate limit.
14.7 CITY shall be entitled, upon request and without expense, to receive copies of the
policies and all endorsements thereto as they apply to the limits required by the
CITY, and may make a reasonable request for deletion, revision, or modification of
particular policy terms, conditions, limitations or exclusions (except where policy
provisions are established by law or regulation binding upon either of the parties
hereto or the underwriter of any such policies). Upon such request by the CITY,
PROVIDER shall exercise reasonable efforts to accomplish such changes in policy
coverage and shall pay the cost thereof.
14.8 PROVIDER agrees that with respect to the above-required insurance, all insurance
contracts and Certificate(s) of Insurance will contain the following required
provisions:
14.8.1 With the exception of Workers' Compensation and Professional Liability
policies, name the CITY and its officers, employees, officials, agents, and
volunteers as additional insureds in respect to operations and activities of, or on
behalf of, the named insured performed under the Agreement with the CITY.
14.8.2 An endorsement stating that PROVIDER's insurance shall be deemed primary
and that any self-funded or commercial coverage maintained by the CITY shall
not be called upon to contribute to loss recovery.
14.8.3 PROVIDER's Workers' Compensation and Employers' Liability policy will
provide a waiver of subrogation in favor of the CITY.
14.9 PROVIDER shall notify the CITY in the event of any notice of cancellation, non-
renewal or material change in coverage and shall give such notices not less than
thirty(30) days prior to the change, or ten (10) days' notice for cancellation due to
nonpayment of premiums, which notice must be accompanied by a replacement
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Certificate of Insurance. All notices shall be given to the CITY at the following
address:
City of Fort Worth
Attn: Ron Josselet, Human Resources Manager
Occupational Health & Safety/Workers' Compensation Division
1000 Throckmorton Street
Fort Worth, Texas 76102
A copy must also be sent to the CITY's Risk Manager at the same address.
14.10 If PROVIDER fails to maintain the aforementioned insurance, or fails to secure and
maintain the aforementioned endorsements, the CITY may obtain such insurance,
and deduct and retain the amount of the premiums for such insurance from any sums
due under the Agreement; however, procuring of said insurance by the CITY is an
alternative to other remedies the CITY may have, and is not the exclusive remedy
for failure of PROVIDER to maintain said insurance or secure such endorsement. In
addition to any other remedies the CITY may have upon PROVIDER's failure to
provide and maintain any insurance or policy endorsements to the extent and within
the time herein required, the CITY shall have the right to order PROVIDER to stop
work hereunder, and/or the right to withhold any payment(s) that become due to
PROVIDER hereunder until PROVIDER demonstrates compliance with the
requirements hereof.
14.11 Nothing herein contained shall be construed as limiting in any way the extent to
which PROVIDER may be held responsible for payments of damages to persons or
property resulting from PROVIDER's or its subcontractors' performance of the
work covered under this Agreement.
15. COMPLIANCE WITH LAWS, ORDINANCES, RULES AND REGULATIONS
In fulfilling its obligations under this Agreement, PROVIDER agrees to comply with all
applicable federal, state and local laws, ordinances, rules and regulations. If the CITY
notifies PROVIDER of any violation of such laws, ordinances, rules or regulations,
PROVIDER shall immediately desist from and correct the violation.
16. NON-DISCRIMINATION COVENANT
PROVIDER, for itself, its personal representatives, assigns, subcontractors and successors
in interest, as part of the consideration herein, agrees that in the performance PROVIDER's
duties and obligations hereunder, it shall not discriminate in the treatment or employment of
any individual or group of individuals on any basis prohibited by law. If any claim arises
from an alleged violation of this non-discrimination covenant by PROVIDER its personal
representatives, assignees, subcontractors or successors in interest, PROVIDER agrees to
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City of Fort Worth and Nova HealthCare,P.A.
assume such liability and to indemnify and defend the CITY and hold the CITY
harmless from such claim.
17. NOTICES
Notices required pursuant to the provisions of this Agreement shall be conclusively
determined to have been delivered when (i) hand-delivered to the other party, its agents,
employees, servants or representatives; (ii) delivered by facsimile with electronic
confirmation of the transmission; or (iii) received by the other party by United States Mail,
registered, return receipt requested, addressed as follows:
To CITY: To PROVIDER
City of Fort Worth Nova Healthcare, P.A.
Attn: Ron Josselet Attn: Shelton Frey
1000 Throckmorton Address: 2425 Foutainview, Suite 200
Fort Worth TX 76102-6311 Houston, TX 77057
Facsimile: (817) 392-7766 Facsimile: 713.333.2900
E-mail: Email: sheltonfrey @n-o-v-a.com
Ron.Josselet@fortwoi,thtexas.gov
With copy to City Attorney's Office
at same address.
18. SOLICITATION OF EMPLOYEES
Neither the CITY nor PROVIDER shall, during the term of this Agreement and
additionally for a period of one year after its termination, solicit for employment or
employ, whether as employee or independent contractor, any person who is or has been
employed by the other during the term of this Agreement, without the prior written consent
of the person's employer.
19. GOVERNMENTAL POWERS
- It is understood and agreed that by execution of this Agreement, the CITY does not waive
or surrender any of its governmental powers.
20. NO WAIVER
The failure of the CITY or PROVIDER to insist upon the performance of any term or
provision of this Agreement or to exercise any right granted herein shall not constitute a
waiver of the CITY's or PROVIDER's respective right to insist upon appropriate
performance or to assert any such right on any future occasion.
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City of Fort Worth and Nova HealthCare,P.A.
21. GOVERNING LAW/VENUE
This Agreement shall be construed in accordance with the internal laws of the State of
Texas. If any action, whether real or asserted, at law or in equity, is brought on the basis of
this Agreement, venue for such action shall lie in state courts located in Tarrant County,
Texas or the United States District Court for the Northern District of Texas, Fort Worth
Division.
22. SEVERASILITY
If any provision of this Agreement is held to be invalid, illegal or unenforceable, the
validity, legality and enforceability of the remaining provisions shall not in any way be
affected or impaired.
23. FORCE MAJEURE
The CITY and PROVIDER shall exercise their best efforts to meet their respective duties
and obligations as set forth in this Agreement. If either party is unable, either in whole or
part, to fulfill its obligations under this Agreement due to acts of God; strikes, lockouts, or
other industrial disturbances; acts of public enemies; wars; blockades; insurrections; riots;
epidemics; public health crises; earthquakes; fires; floods; restraints or prohibitions by any
court, board, department, commission, or agency of the United States or of any state;
declaration of a state of disaster or of emergency by the federal, state, county, or City
government in accordance with applicable law; issuance of a Level Orange or Level Red
Alert by the United States Department of Homeland Security; any arrests or restraints; civil
disturbances; explosions; or some other reason beyond the party's reasonable control (each
a "Force Majeure Event"), the obligations so affected by such Force Majeure Event will be
suspended only during the continuance of such event.
24. HEADINGS NOT CONTROLLING
Headings and titles used in this Agreement are for reference purposes only and shall not be
deemed a part of this Agreement.
25. REVIEW OF COUNSEL
The parties acknowledge that each party and its counsel have had the opportunity to review
and revise this Agreement and that the normal rules of construction to the effect that any
ambiguities are to be resolved against the drafting party shall not be employed in the
interpretation of this Agreement or exhibits hereto.
26. AMENDMENTS /MODIFICATIONS /EXTENSIONS
No extension, modification, or amendment of this Agreement shall be binding upon a party
hereto unless such extension, modification, or amendment is set forth in a written
instrument that is executed by both parties.
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City of Fort Worth and Nova HcalthCare,P.A.
27. SIGNATURE AUTHORITY
Each person signing this Agreement hereby warrants that he/she has the legal authority to
execute this Agreement on behalf of his/her respective party, and further warrants that such
binding authority has been granted by proper order, resolution, ordinance, or other
authorization of the entity. The other party is fully entitled to rely on this warranty and
representation in entering into this Agreement.
28. ENTIRETY OF AGREEMENT
This instrument (including any exhibits and attachments hereto and any documents
incorporated herein by reference) contains the entire understanding and agreement
between the CITY and PROVIDER, their assigns and successors in interest, as to the
matters contained herein. Any prior or contemporaneous oral or written agreement
purporting to vary from the terms of this document is hereby declared null and void.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement in multiples this
')37fT,4ay of January, 2015.
CITY OF FORT WORTH: NO +,
By: By:
Susa A anis, Assistant City Manager Tit e: Chie perating Officer
Date: 1 l a.S I a-OlS Date: II 1
ATTEST: fop EST:
By: —g S•
Mary yser, dWslcreOry $ Q ' General Co r sel
APPROVED AS TO FORM AND ���
LE ITY:
Y•
Denis cElro , ssistant City Attorney
CONTRACT AUTHORIZATION: FC--�APIYV K�A L RECORD
SECRETARY
M&C: C-27056 WORT] TX
Date Approved: 10/28/2014
Professional Services Agreement Page 16 of 25
City of Fort Worth and Nova HealthCare,P.A.
EXHIBIT A - SCOPE OF SERVICES
A.I. PROVIDER FACILITIES
A.1.1 PROVIDER's facilities shall be of adequate size and capability to provide all necessary
health care for injured employees as outlined in this Agreement and its exhibits. These
facilities must be operated and maintained to ensure a healthful and safe environment
for CITY employees.
A.1.2 Clinic Locations
A.1.2.1 PROVIDER must operate sufficient clinic locations in the Fort Worth/Dallas
area to provide convenient occupational health care services to CITY
employees. The CITY will primarily utilize facilities located in Fort Worth.
However CITY employees may access any other PROVIDER health care
facilities located in the Fort Worth/Dallas metroplex, or any other PROVIDER
locations in Texas and the United States as necessary.
A.1.2.2PROVIDER operates two (2) clinic locations in Fort Worth, seven (7)
additional clinic locations in the Fort Woith/Dallas Metroplex area, and thirty-
six (36) other locations around the United States. The CITY will primarily
utilize PROVIDER's Fort Worth locations as detailed in PROVIDER's
Response to City RFP No. 14-0225, a copy of which proposal is attached as
Exhibit "C" to the Agreement. However, CITY personnel can access any other
PROVIDER location as necessary.
A.1.2.3Primary Clinic Location—
The facility listed below shall be designated as the primary facility for use of
CITY Employees. Hours of operation of the primary facility shall at a
minimum be 8:30 a.m. to 6:00 p.m. Monday through Friday. However, it is
desirable that PROVIDER provide extended hours during weekdays and on
weekends and holidays at the designated primary facility and/or other facilities
as a means to better accommodate CITY employees who work evening, night,
weekend and/or holiday shifts. The designated clinic facility that shall serve as
CITY's primary clinic facility is:
1106 Alston Avenue
Fort Worth, TX 76104
Phone: 817.332.0660
Fax: 817.332.0770
Hours of Operation:
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City of Fort Worth and Nova HealthCare,P.A.
A.1.3 Wait Times
Wait times for CITY employees for medical treatment and/or other occupational health
care services shall not exceed reasonable time limits.
A.1.4 Hours of Operation
PROVIDER must make contracted services available weekdays, Monday through
Friday from 8:30 a.m. to 6:00 p.m. The CITY considers these hours of operation as a
minimum requirement and would provide favorable consideration to providing medical
services at additional times.
A.1.5 Accreditation
If PROVIDER currently is not accredited by the Urgent Care Center Accreditation
(UCCA) Program and/or the Joint Commission on Accreditation of Healthcare
Organizations (The Joint Commission), PROVIDER agrees to consider seeking such
accreditation.
A.2 CLINIC PERSONNEL
A.2.1 PROVIDER's health care practitioners must be credentialed, experienced in
occupational medicine, and possess documented expertise in the evaluation, treatment,
oversight, and recovery of employees injured on the job. This expertise must also
encompass an effective system of communication with the CITY and their agents to
ensure prompt delivery of necessary services and overall coordination of the CITY's
programs.
A.2.2 PROVIDER must utilize Texas licensed medical doctors and other licensed health care
practitioners and administrative staff sufficient to perform all necessary health care and
other required services. PROVIDER must exercise due diligence to ensure health care
practitioners are properly credentialed in their respective and specific areas of medical
practice.
A.2.3 PROVIDER's medical doctors and health care practitioners must be familiar with and
utilize evidenced based medicine in the evaluation, treatment, oversight, and recovery
of employees injured on the job as required by the Texas Labor Code and related Rules.
A.2.4 Treating Doctors
A.2.4.1 PROVIDER agrees to employ or contract with occupational medicine
physicians to provide occupational injury medical treatment and care for
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City of Fort Worth and Nova HealthCare,P.A.
injured CITY employees. PROVIDER physicians shall be in good standing
with State of Texas regulatory agencies including the Texas Department of
Insurance, Division of Workers' Compensation (DWC) regarding being an
approved doctor on the Division's Approved Doctors List.
A.2.4.2 PROVIDER physicians shall perfonn and function as Treating Doctors, in
accordance with the Texas Labor Code and related Rules.
A.3 PANEL OF SPECIALTY PHYSICIANS AND HEALTH CARE PROVIDERS
A.3.1 PROVIDER agrees to assist the CITY to establish and maintain a panel of specialized
medical professionals/ physicians and other health care providers for referral as
necessary in the appropriate treatment of the CITY's employees who are injured in the
course and scope of their employment. PROVIDER also agrees to maintain the panel
during the initial term of this Agreement, as well as any of the option terns.
A.3.2 The panel will be composed of medical professionals / physicians, including but not
limited to Neurologists, Orthopedists / Orthopedic Surgeons, Neurologists /
Neurosurgeons, Plastic Surgeons, Psychologists, Psychiatrists, Pain Management
Specialists, Chiropractors, Physical and Occupational Therapists, Pain Management
Specialists, Oncologists, Pulmonologists and Cardiovascular Surgeons.
A.3.3 Each medical specialist must be willing to accept workers' compensation patients and
agree to be paid for services in accordance with the Texas Labor Code and related
Rules for medical services and fees.
A.3.4 PROVIDER agrees that Treating Doctors shall monitor performance of referral
specialists and other health care providers as to the following:
A.3.4.1 Usage of Treatment Guidelines adopted by the Texas Department of Insurance
—Department of Workers' Compensation ("TDI-DWC")
A.3.4.2 Usage of Return-To-Work Guidelines adopted by the TDI-DWC
A.3.4.3 Medical Outcomes
A.3.4.4 Return-To-Work Outcomes
CITY shall require frequent reports as to the performance of referral specialists and
other health care providers relating to A.3.4.1 through A.3.4.4 above.
A.3.5 PROVIDER also agrees to replace, if necessary, any or all of panel members as
warranted and agreed upon by the CITY.
A.3.6 PROVIDER shall coordinate with the CITY regarding the initial panel of doctors and
any changes to the members of the panel.
A.4 OCCUPATIONAL INJURY MEDICAL TREATMENT AND CARE
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A.4.1 PROVIDER shall provide reasonable and necessary health care services to CITY
employees injured in the course and scope of their employment with the CITY, as
defined and instructed in the Texas Labor Code and related Rules.
A.4.2 Employees injured on the job will be referred to the PROVIDER medical facilities as
appropriate by the CITY, as a preferred provider of health care services. Employees of
the CITY currently retain the right to choose a different initial treating doctor as
allowed in the Texas Labor Code and related Rules.
A.4.3 If the injured employee chooses to seek initial and subsequent health care with
PROVIDER then the PROVIDER will become the employee's treating doctor and will
perform all of the necessary functions and responsibilities of a treating doctor as
required by the Texas Labor Code and related Rules.
AAA PROVIDER shall accelerate and expedite treatment and/or referrals for treatment of the
following CITY employees, in accordance with Section 504.055 of the Texas Labor
Code: (1) peace officers; (2) emergency medical care attendants, emergency medical
technicians, and paramedics; and (3) fire fighters.
A.4.5 Treatment Guidelines
PROVIDER shall specifically provide medical treatment and render services in
accordance with Treatment Guidelines adopted by TDI-DWC in the Rules, Chapter
137, "Disability Management". Any treatment that is not covered by the Guidelines
shall be documented and shall be based on other credible evidence-based medicine as
defined in Section 401.011(18-a) of the Texas Labor Code.
A.4.6 Return-To-Work Guidelines
PROVIDER shall specifically utilize the disability duration guidelines adopted by TDI-
DWC in the Rules, Chapter 137, "Disability Management, § 137.10" in coordinating an
employee's safe return to the CITY after an on the job injury. Specifically,
PROVIDER will effectively communicate and coordinate with the CITY's Return to
Work Program to ensure that injured employees are safely and appropriately returned to
restricted (modified) or full duty employment. Deviations from these Return-To-Work
Guidelines shall be documented in a treatment plan designed to (1) provide required
treatment of the employee in accordance with subsection A.4.5 above and (2) effect the
earliest return to work date the employee is medically able to do so.
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City of Fort Worth and Nova HealthCare,P.A.
A.4.7 Restrictions to Duty
PROVIDER shall recognize and discuss with injured CITY employees the general
availability of restricted or limited duty assignments provided by the CITY.
PROVIDER shall identify appropriate restrictions to duty based on CITY provided
detailed physical demand requirements of the injured employee's position, or of any
limited duty assignments that may be available to the injured employee.
A.4.8 DWC-073 "Work Status Report"
PROVIDER shall ensure that health care providers completely and accurately fill out
the TDI-DWC form DWC-073 "Work Status Report" on each CITY employee for each
medical evaluation or for medical treatment provided. PROVIDER shall provide each
such DWC-073 form to the CITY Occupational Health and Safety / Workers'
Compensation Division (the "OHS") within one (1) work day of the employee's office
visit or medical treatment event.
A.4.9 Preauthorization Requests; Requests for Reconsideration
A.4.9.1 PROVIDER shall ensure that requests for pre-authorization of medical services
and requests for reconsideration of pre-authorization denials shall include all
necessary medical documentation based upon the Treatment Guidelines to
support and justify the request prior to submission to the CITY's third party
claims administrator.
A.4.9.21n accordance with the Texas Labor Code §504.055, PROVIDER shall
accelerate and expedite the preparation and submission of preauthorization
requests relating to the following CITY employees: (1) peace officers; (2)
emergency medical care attendants, emergency medical technicians, and
paramedics; and (3) fire fighters.
A.4.9.3PROVIDER agrees to expedite preparation and submission of all
preauthorization requests and requests for reconsideration to the CITY's
contracted third party claims administrator so as to minimize the amount of time
an employee may be off work, on limited duty, and/or awaiting medical
services. CITY agrees to include expedited preauthorization determinations and
expedited determinations of requests for reconsideration in the third party
claims administrator's account handling instructions for the CITY.
A.5 REPORTS
A.5.1 CITY shall require quarterly and annual reports, or as otherwise required by CITY, as
to the performance of Treating Doctors, referral specialists and other health care
providers to include,but not necessarily limited to the following:
A.5.1.1 Usage of Treatment Guidelines adopted by the TDI-DWC
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City of Fort Worth and Nova HealthCare,P.A.
A.5.1.2 Usage of Return-To-Work Guidelines adopted by the TDI-DWC
A.5.1.3 Medical Outcomes
A.5.1.4 Return-To-Work Outcomes
A.5.2 CITY shall require additional reports including but not necessarily limited to the
following:
A.5.2.1 Utilization Report of CITY employees compared to utilization of other
employer (including other municipalities) in the Fort Worth/Dallas
Metroplex, to include injury frequency, cost by body area, age profile,
male to female profile, case duration and cost, referral utilization and
management, return-to-work outcomes and management
A.5.2.2 Average clinic wait tunes of CITY employees
A.5.2.3 Patient / Employee Satisfaction with medical treatment and services
provided
A.5.2.4 Services provided by Treating Doctor, and by category of treatment
and service provided—number and cost
A.5.2.5 Average length of time from date of medical evaluation to date of
submission of preauthorization requests and requests for
reconsideration
A.5.2.6 Monthly Report of CITY employees who fail to keep medical and/or
other health care appointments — dates and type of appointment.
Infortnation and data for this report shall be captured and reported by
City Department.
A.6 WORKERS' COMPENSATION HEALTH CARE NETWORK
A.6.1 Certified Workers' Compensation Health Care Network
PROVIDER must be willing to participate in a workers' compensation health care
network certified under Chapter 1305 of the Insurance Code, if the CITY determines
that provision of medical benefits through a workers' compensation health care network
is available and practical to the CITY.
A.6.2 Direct Contract Network
In the event the CITY chooses to provide medical benefits to injured employees by
directly contracting with health care providers or through a health benefits pool
established under Chapter 172 of the Local Government Code and in accordance with
Section 504.053 of the Texas Labor Code, PROVIDER must be willing to participate in
such a panel or network of health care providers specifically developed by or on behalf
of CITY.
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City of Fort Worth and Nova Healthcare,P.A.
EXHIBIT B—OCCUPATIONAL INJURY MEDICAL TREATMENT AND CARE;
SCHEDULE OF COMPENSATION
B.1 Medical services/health care rendered by PROVIDER and the panel of medical specialists to
CITY employees injured in the course and scope of their employment with the CITY shall be
provided in accordance with the Texas Labor Code and Texas Department of Insurance,
Division of Compensation adopted Rules.
B.2 Compensation to PROVIDER and the panel of medical specialists shall be paid by the CITY
in accordance with the Medical/Professional Services and Fee Guidelines as specified in the
Texas Labor Code and Texas Department of Insurance, Division of Compensation adopted
Rules.
B.3 The following provisions of the Texas Labor Code relating to medical treatment and care,
compensation for services, reimbursement and medical fees specifically apply:
Chapter 408 Workers' Compensation Benefits
Sub-Chapter B. Medical Benefits
Chapter 409 Compensation Procedures
Section 409.009
Section 409.0091
Chapter 413 Medical Review
Sub-Chapter A General Provisions
Sub-Chapter B Medical Services and Fees
Sub-Chapter C Dispute Resolution
Sub-Chapter D Health Care Providers
Chapter 504 Workers' Compensation Coverage for Employees of Political
Subdivisions
Sub-Chapter C Benefits and Offsets
Section 504.055 Expedited Provision of Medical Benefits
Section 504.056 Intent of Expedited Provision of Medical Benefits
B.4 The following provisions of the Texas Department of Insurance, Division of Workers'
Compensation Rules (Texas Administrative Code,Title 28, Part 132) relating to medical
treatment and care, compensation for services, reimbursement and medical fees specifically
apply:
Chapter 126 General Provisions Applicable to All Benefits
Rule 126.9 Choice of Treating Doctor and Liability for Payment
Rule 126.14 Treating Doctor Examination to Define the Compensable
Injury
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Rule 126.17 Guidelines for Examination by a Treating Doctor or
Referral Doctor after a Designated Doctor Examination to
Address Issues Other Than Certification of Maximum Medical
Improvement and the Evaluation of Permanent Impairment
Chapter 133 General Medical Provisions
Sub-Chapter A General Rules for Medical Billing and Processing
Sub-Chapter B Health Care Provider Billing Procedures
Sub-Chapter C Medical Bill Processing/Audit by Insurance Carrier
Sub-Chapter D Dispute and Audit of Bills by Insurance Carriers
Sub-Chapter G Electronic Medical Billing, Reimbursement, and
Documentation
Chapter 134 Guidelines for Medical Services, Charges and Payments
Sub-Chapter A Medical Reimbursement Policies
Sub-Chapter B Miscellaneous Reimbursement
Sub-Chapter C Medical Fee Guidelines
Sub-Chapter E Health Facility Guidelines
Sub-Chapter F Pharmaceutical Fees
Sub-Chapter G Prospective and Concurrent Review of Health Care
Sub-Chapter I Medical Bill Reporting
Sub-Chapter J Reviews and Audits
Chapter 138 Disability Guidelines
Sub-Chapter A General Provisions
Sub-Chapter C Treatment Guidelines
Chapter 140 Dispute Resolution/General Provisions
Rule 140.6(d) Claims for Reimbursement of Medical Benefits
Chapter 180 Monitoring and Enforcement
Sub-Chapter B Medical Benefit Regulation
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Official site of the City of Fort Worth,Texas
CITY COUNCIL AGENDA FORT
COUNCIL ACTION: Approved on 10/28/2014
DATE: 10/28/2014 REFERENCE NO.: **C-27056 LOG NAME: 14CONCENTRA OHS
CODE: C TYPE: CONSENT PUBLIC NO
HEARING:
SUBJECT: Authorize Execution of a Professional Services Agreement with Occupational Health
Centers of the Southwest, P.A. d/b/a Concentra Medical Centers, for Non-Injury
Occupational Health Care Services for an Anticipated Annual Cost of$316,106.17 and
Authorize Execution of Professional Services Agreements with Primary Health, Inc. d/b/a
Care Now, Occupational Health Centers of the Southwest, P.A. d/b/a Concentra Medical
Centers, Texas Health Harris Methodist Hospital Fort Worth d/b/a Texas Health Harris
Methodist Occupational Health and Nova HealthCare, P.A., as Preferred Providers of
Occupational Injury Medical Care and Treatment Services with All Costs to be Billed to
Individual Claim Files (ALL COUNCIL DISTRICTS)
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize the execution of a Professional Services Agreement with Occupational Health Centers
of the Southwest, P.A. d/b/a Concentra Medical Centers, as the City's sole provider of non-injury
occupational health care services with an estimated annual cost of$316,106.17; and
2. Authorize the execution of individual Professional Services Agreements with Primary Health, Inc.
d/b/a Care Now, Occupational Health Centers of the Southwest, P.A. d/b/a Concentra Medical
Centers, Texas Health Harris Methodist Hospital Fort Worth d/b/a Texas Health Harris Methodist
Occupational Health and Nova HealthCare, P.A., as preferred providers of occupational injury
medical treatment and services with all costs to be billed to individual claim files as allocated loss
expenses.
DISCUSSION:
The purpose of this Mayor and Council Communication is to approve Agreements for both injury and
non-injury related occupational health care.
On September 29, 2009, (M&C C-23812) the City Council authorized execution of a contract with
Occupational Health Centers of the Southwest, P.A. d/b/a Concentra Medical Centers (Concentra), to
provide both non-injury occupational health care services to the City of Fort Worth and to provide
medical treatment and services to employees injured on the job. The final renewal option was set to
expire on September 30, 2014, but the City Council authorized a three-month extension through
December 31, 2014 to facilitate a new bidding process (M&C C-26914).
Request for Proposals (RFP) No. 14-0225 was issued and advertised in the Fort Worth Star-
Telegram on August 13, 2014, seeking proposals for a medical provider(s) of occupational health
care services. A total of four proposals were received in response to the RFP. The four proposers
were Primary Health, Inc. d/b/a Care Now (Care Now), Occupational Health Centers of the
Southwest, P.A. d/b/a Concentra Medical Centers, Texas Health Harris Methodist Hospital Fort Worth
d/b/a Texas Health Harris Methodist Occupational Health (Harris) and Nova Health Care, P.A.
(Nova).
The proposal evaluation factors included responsiveness to the RFP, the medical provider's capability
and expertise to provide the services requested, MBE participation and cost. Proposals were
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M&C Review Page 2 of 3
reviewed by an evaluation committee consisting of staff from the Human Resources, Police and Fire
Departments and the M/WBE Office. The evaluation committee recommends that Concentra be
awarded a contract for Non-Injury Health Care Services and that all four proposers be awarded
contracts as preferred providers for Occupational Injury Medical Care and Treatment Services.
Non-Injury Occupational Health Care Services:
Concentra has provided occupational health care services to the City for the past 14
years. Concentra is one of the nation's largest occupational health care providers and currently
provides services to the City for both occupational injury medical treatment and for non-injury
occupational health care services. The non-injury services being provided include alcohol and drug
screens, flu shots and other types of vaccinations, medical screenings, Department of Transportation
commercial driver's physicals, pre-employment physicals and return-to-work physical abilities tests.
As noted above, the evaluation committee recommends engaging Concentra as the sole provider for
these non-injury occupational health care services, which have an estimated annual cost of
$316,106.17.
Occupational Injury Medical Care and Treatment Services:
Care Now was founded in 1993 and operates 24 occupational injury and urgent care clinic locations
in the Fort Worth/Dallas Metroplex, five of which are in Fort Worth. Care Now is accredited by the
Accreditation Association for Ambulatory Health Care, Inc.
Concentra Medical Centers is a subsidiary of Humana, Inc., and was established in 1979. Concentra
operates 16 occupational injury and urgent care clinic locations in the Fort Worth/Dallas Metroplex,
two locations of which are in Fort Worth. As noted above, Concentra has previously provided these
services to the City.
Texas Health Harris Methodist Hospital has provided medical services to Tarrant County since 1930
and is accredited by the Joint Commission on Accreditation of Healthcare Organizations. Texas
Health Harris Methodist operates two occupational injury clinics in Fort Worth.
Nova HealthCare, P.A., was founded in 1993 and operates nine occupational injury clinics in the Fort
Worth/Dallas Metroplex, two of which are in Fort Worth.
By contracting with all four providers for occupational injury medical care, treatment and services, the
City is able to offer City employees a wide choice of primary occupational medical treatment
providers through 11 Fort Worth clinics and 40 additional clinic locations throughout the Fort
Worth/Dallas Metroplex. Contracting with four providers also enables Staff to work with these
preferred providers to achieve better return-to-work outcomes for City employees, to provide a wide
range of quality health specialty providers and to better manage the costs of workers' compensation
medical care.
Medical care and treatment services for occupationally injured City employees are characterized as
allocated loss adjustments and are invoiced to the individual claim files of each injured worker. The
costs for these services are included in the amounts allocated in the budget for workers'
compensation claims. Claims are processed and paid on behalf of the City by CorVel Enterprise
Comp., the City's contracted Third Party Workers' Compensation Claims Administrator(City
Secretary Contract No. 44004). Medical care and treatment services fees are paid at State of Texas
regulated medical fee guidelines adopted by the Texas Department of Insurance, Division of Workers'
Compensation and there is no variation in fee amounts.
M/WBE OFFICE - Occupational Health Centers of the Southwest, P.A. d/b/a Concentra Medical
Centers is in compliance with the City's BDE Ordinance by committing to 10 percent MBE (African
American) participation on this project for the Non-Injury Occupational Health Care and other related
health care services. The City's MBE (African American) goal on this project is 10
percent. Additionally, the Occupational Injury Medical Care and Treatment Services Agreements for
this solicitation is not applicable to the goal because the purchase of these types of services is from
source(s) where subcontracting opportunities are negligible.
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M&C Review Page 3 of 3
RENEWAL TERMS - On City Council approval, all of these Agreements will have an initial three-year
term, beginning January 1, 2015 and each Agreement will allow for up to two, one-year
renewals. Execution of the renewal Agreements will not require additional City Council authority,
provided that funds have been appropriated to pay the City's obligations during the renewal terms.
FISCAL INFORMATION/CERTIFICATION:
The Financial Management Services Director certifies that funds are available in the current operating
budget, as appropriated, of the Workers' Compensation Insurance Fund.
TO Fund/Account/Centers FROM Fund/Account/Centers
FE73 539120 0147310 $316,106.17
Submitted for City Manager's Office by: Susan Alanis (8180)
Originating Department Head: Brian Dickerson (7783)
Additional Information Contact: Margaret Wise (8058)
ATTACHMENTS
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