WORKERS COMPENSATION MANAGED CARE ARRANGEMENT AGREEMENT
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AGREEMENT
Between
CITY OF CLEARWATER
And
CORVEL CORPORATION
This document represents an agreement between the City of Clearwater, hereinafter
referred to as "CITY", and CorVel Corporation, hereinafter referred to as "CaRVEL".
This agreement continues a business relationship between the parties hereto originally
established in 1997. This agreement's purpose is to continue the implementation ofa
comprehensive workers' compensation managed care arrangement (MCA) for the CITY
in the State of Florida, and the servicing of CITY'S injured employees whose claims are
self-administered by the CITY in compliance with Chapter 440, Florida Statutes (Florida
Workers' Compensation Law).
In consideration of the premises hereof, and the mutual promises and agreements made
herein, the parties hereto, intending to be legally bound, hereby agree to the provisions set
forth in this agreement and in the CITY'S Managed Care Arrangement which include, but
are not limited to the following:
OBLIGA TIONS OF CORVEL:
1 ) CaRVEL will continue to develop and maintain, through credentialing and re-
credentialing of medical providers, the operations of a MCA Preferred Provider
Network (CorCare) in the service area consisting of Pine lias, Hillsborough, and Pasco
Counties which include primary care physicians and other medical specialist, and other
health care providers satisfactory to CITY, to include hospitals, clinics, and ancillary
health care services.
2) CaRVEL will implement and maintain utilization management programs and services
as defined in the MCA.
3) CaRVEL will assist, through communication with CITY'S workers' compensation
adjusters, the CITY'S injured employees with grievance procedures as defined in
the MCA.
4) CORVEL will develop and maintain the CorCare Network Quality Assurance
program and provide case management services as defined in the MCA.
5) CaRVEL will assist CITY with MCA educational seminars.
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6) COR VEL will assist CITY with preparation of its MCA as needed and file the same
with Florida's Agency For Health Care Administration (AHCA) along with semi-
annual updated provider lists as provided by Florida law.
7) COR VEL will invoice CITY monthly for use of its medical care network and its
managed care services in accordance with the pricing schedule set forth in
paragraph 19 hereof
8) CORVEL will provide sample education materials for CITY and will assist CITY
with proper distribution of such materials.
9) CORVEL will provide directory updates to CITY for appropriate channeling into
the CorCare Network.
10) CORVEL will provide reports to CITY monthly substantiating cost savings through
the CITY'S MCA.
11) CORVEL will work with CITY workers' compensation adjusters to:
a) Notify employees of the necessity of using the MCA;
b) Direct employees to CorCare providers;
c) Assist employees with return to work opportunities.
OBLIGATIONS OF CITY:
12) CITY will refer all inpatient and outpatient invoices, except pharmacy invoices to
CORVEL for all workers' compensation cases regardless of date of accident.
COR VEL will then review each invoice submitted, reduce to fee schedule, apply all
PPO discounts, and return the invoice to CITY in adequate time for CITY to pay
each invoice within the time allotted for payment of invoices pursuant to Florida
Workers' Compensation Law. Hospital invoices shall be audited by CORVEL only if
requested by CITY.
13) CITY will pay CORVEL for services rendered within thirty (30) days of the date of
receipt by CITY of an accurate invoice from COR VEL.
MISCELLANEOUS PROVISIONS:
14) The term of this agreement is for a period of one (1) year from its effective date. This
agreement may be renewed for two (2) additional one (1) year periods on the same
terms and condition if mutually agreed to by the parties hereto. Renewal shall be
automatic unless either party shall give a Notice ofIntent to terminate the Agreement
2.
within thirty (30) days of the renewal date in accordance with paragraph 15 hereof
15) The terms of paragraph 14 hereof to the contrary notwithstanding, this agreement can
be terminated by either party with or without cause upon thirty (30) days written
notice submitted at any time. It is the expressed intent of the parties that the business
relationship between the parties hereto shall last only so long as the parties are
mutually satisfied with the business relationship existing between the parties.
16) COR VEL, will, at its own expense, maintain, at all times during the term of the
agreement, the required professional liability, errors and omissions, workers'
compensation, general and auto liability insurance coverages as set forth on Exhibit
A attached hereto and made a part hereof
17) This contract is expressly conditioned upon COR VEL adding to either its provider
network or to CITY'S MCA those medical providers desired by CITY provided such
providers can meet CorVel's credentialing requirements.
18) CORVEL shall be responsible for the recommendations, acts or omissions of any of
its employees, agents, representatives, or independent contractors in connection
with the provision of its managed care services as described in its marketing
brochures and/or service proposals or RFP response as provided to CITY, and shall
indemnify, defend, and hold harmless CITY, its agents, representatives, elected
officials, and employees, from any claims, actions, suits, proceedings, costs,
expenses, damages, injuries, and liabilities, including attorney's fees, arising from its
recommendations, acts or omissions. The above stated rights to indemnification shall
not apply (a) to any case where CITY, its agents, representatives, or employees in any
way modify or disregard COR VEL'S recommendations or fail to implement them in
a timely manner or (b) to the extent the cause of action or liability arises from the
negligent acts or omissions or willful misconduct of CITY, its employees, agents,
employees, elected officials, or representatives.
19) The parties hereby agree to CORVEL'S prices for its managed care services to CITY
as follows:
a) Standard fees are $1.25 per line (line means CPT code) with a two (2) line
minimum for review of invoices for medical services covered by the State of
Florida's workers' compensation fee schedule;
b) Standard fees are $1.40 per line with a two (2) line minimum for review of
invoices for medical services not covered by the State of Florida's workers'
compensation fee schedule;
c) A fee of $68.00 per hour for telephonic and field case management of cases that
are specifically referred to CORVEL by CITY;
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d) If CITY uses, which it is not required to use, CorCare RX Pharmacy program
CORVEL shall receive 30% of any savings, with no charge to be made ifno
saVIngs occurs.
e) CORVEL shall receive 30% of any savings generated from its PPO re-pricing
based on medical provider discounts that CORVEL has negotiated into its
managed care network.
f) Based on the anticipated usage ofCORVEL'S Managed Care Network by City
and the level of expenditures for workers' compensation medical benefits paid by
the City in the past two years, together with the PPO savings to inure to the City
by virtue of City's use of the CORVEL Managed Care Network, the parties
anticipate a net expenditure annually by CITY of less than $25,000.
20) The effective date of this agreement will be January 1,2000, but if the City Attorney
of Clearwater determines that this agreement needs to be ratified and confirmed by
the Clearwater City Commission, then this agreement will be voidable by CITY
until such time as the agreement is ratified and confirmed by the Clearwater City
Commission.
CORVEL CORPORATION,
a, Delaware Corporation
CITY OF CLEARWATER,
a Florida Municipal Corporation
By g"nJklJJ8oM-
Its g811y Autq.onz~ Representative
Date: I ~ } :) 1< } 9 9
By
Date:
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EXHIBIT A
to
Agreement
Between
CITY OF CLEARWATER
And
CORVEL
Dated
December, 1999
INSURANCE REQUIREMENTS
1. Insurance. CORVEL shall furnish, pay for, and maintain during the life of the contract with
the City the insurance coverages shown below:
a. General Liability insurance on an "occurrence" basis in an amount not less than
$500,000 combined single limit Bodily Injury Liability and Property Damage
Liability.
b. Business Auto Liability insurance on an "occurrence" basis in an amount not less
than $500,000, for liability arising out of operation, maintenance or use of any auto,
including owned, non-owned and hired automobiles and employee non-ownership
use.
c. Worker's Compensation Insurance applicable to its employees, if any, for statutory
coverage limits in compliance with Florida laws.
d. Professional Liability/Malpractice/Errors or Omissions Insurance with minimum
limits of $1 ,000,000 per occurrence.
2. Additional Insured. The City is to be specifically included as an additional insured on all
liability coverage described above.
3. Notice of Cancellation or Restriction. All policies of insurance must be endorsed to provide
the City with thirty (30) day's notice of cancellation or restriction.
4. Certificates oflnsurance/Certified Copies of Policies, CORVEL shall provide the City with
a certificate or certificates of insurance showing the existence of the coverages required by its
contract with the CITY. CORVEL will maintain these coverages with a current certificate or
certificates of insurance throughout the term stated in the proposal.
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When specifically requested by City in writing, the Vendor will provide City with certified
copies of all policies of insurance as required above. New certificates and new certified
copies of policies, if certified copies of policies have been requested, shall be provided City
whenever any policy is renewed, revised, or obtained from other insurers.
5. The address where such certificates and certified polices shall be sent or delivered is as
follows:
City of Clearwater
Attention: Risk Management
P.O. Box 4748
Clearwater, FL 33758-4748
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