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NOTICE OF INTENT TO RENEW AGREEMENT AND RENEWAL THEREOF TERM FROM 0101/99 TO 12/31/99 _:3 ~ -~ '" ' I I NOTICE OF INTENT TO RENEW AGREEMENT AND RENEWAL THEREOF THE UNDERSIGNED corporations hereby give notice oftheir intention to renew, and by this document do renew, for a new one (1) year term, that certain Agreement between the CITY OF CLEARWATER and CORVEL CORPORATION which became effective January 1, 1997, relating to the development ofa Workers' Compensation "Managed Care Arrangement" (MCA) and the delivery of Workers' Compensation Managed Care Medical Services by CORVEL CORPORATION to the CITY OF CLEARWATER, a copy of said agreement being attached hereto as Exhibit A. The renewed term of one year, which shall be evidenced by this document when this document is duly executed, shall be on the same terms and conditions as the current term and said term shall run from January 1, 1999, through, and including, the last day of December, 1999. CITY OF CLEARWATER, a Florida Municipal Corporation By( ! Michael Roberto City Manager; / Date:x /~ d./ 9f CORVEL CORPORATION, a Delaware Corporation By l J;A1x1AL ';r;-y~tf:; Its Duly Authorized RepresentatI e Date: / I! 2jCi g Document Prepared by: Leo W. Schrader, Attorney Risk Manager City of Clearwater (1) '. ' rp (j) AGREEMENT Between CITY OF CLEARWATER And CORVELCORPORATION lKi~~~~w~~ fEB U 4 19~1 RISK MANAGEMENT This document represents an agreement between the City of Clearwater, hereinafter referred to as "CITY", and CorVel Corporation, hereinafter referred to as "CORVEL". Tile purpose of this agreement is to establish a business relatiunship between the parties hereto for the purpose of developing and implementing a comprehensive workers' compensation managed care arrangement (MeA) for the CITY in the State of Florida, with regard to 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: OBLIGATIONS OF CORVEL: I) CORVEL will 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 Pinellas, 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) CORVEL will implement and maintain utilization management programs and services as defined in the MeA. 3) CORVEL willassist, through communication with CITY'S workers' compensation adjuster(s), the CITY'S injured employees with grievance procedures as defmed in the MCA. IJ{!:~ 1 'f) 'I ') 4) CORVEL will develop and maintain the CorCare Network Quality Assurance program and provide case management services as defined in the MCA. 5) CORVEL will assist CITY with MCA educational seminars. 6) CORVEL will assist CITY with preparation of its MCA 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) CORVEL 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 chann~ling 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. CORVEL 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. 2 ..>, ~ (19 1J 13) CITY shall pay CORVEL for services rendered within thirty (30) days of the date of receipt by CITY ofan invoice from CORVEL. MISCELLANEOUS PROVISIONS: 14) The tenn 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 onthe same tenns and condition if mutually agreed to by the parties hereto. Notice of intent to renew will be given ,- by each PartY within sixty (60) days of the expiration date. 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) CORVEL, 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 CORVEL adding to either its provider network or to CITY'S MCA those medical providers desired by CITY - particularly Morton Plant Hospital and its affiliated Mease hospitals. 18) COR VEL shall be responsible for the recommendations, acts or omissions of any of its employees, agents, representatives, or independent contractors in connection with the provision onts 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 CORVEL'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. 3 f) IV 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; d) If CITY uses, which it is not required to use, COICare 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 of COR VEL'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, 1997, but if the City Attorney of Clearwater determines that this agr~ement 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 ~~~ Date: I j/ ,,/f 7 , 4 '" -: ..-# ~:... ~ '- l- I " I ) S. 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 34618-4748 2