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HomeMy WebLinkAboutMASTER AGREEMENT Licensed CMC Credentialed Medical Service Provider Groups-Amend. 1 to Exhibit 1_A-19-444.pdf DocuSign Envelope ID:8FF556B2-9CE5-49DA-86F7-ECC57741DB42 coU� County of Fresno o� so DEPARTMENT OF PUBLIC HEALTH FxES David Luchini, Director Dr. Rais Vohra, Interim Health Officer July 1, 2022 Community Health Partners Patrick T. Ramirez, President& CEO 45 River Park Place West, Suite 501 Fresno, CA 93720 Re: Addition of Community Health Partners (CHP)to Fresno County Agreement#19-444 (Master Agreement for the Provision of Specialty and Primary Professional Medical Services and Emergency Care) Dear Mr. Ramirez, Fresno County Agreement#19-444, which was approved by the Fresno County Board of Supervisors on September 10, 2019, allows for the addition of specialty and primary professional medical care and emergency care providers to the agreement by mutual agreement and signature. It is our understanding that CHP may, through their provision of care at Community Medical Centers,provide specialty and/or primary professional medical care and emergency care services to the County's Medically Indigent Service Program (MISP) beneficiaries. In order for the County of Fresno to compensate (see Exhibit 5 of the Agreement) CHP for professional medical services that have been provided(see Exhibit 3 of the Agreement)to a MISP beneficiary at a participating affiliated hospital or facility (see Exhibit 4 of the Agreement), CHP would need to be made a party to Master Agreement#19-444. If CHP would like to become a party to Agreement#19-444, please take note of the addition of CHP on the attached Amendment 1 to Exhibit 1 and sign the attached signature page and return it to my staff listed below. I have already signed for the County and the Amendment would become official on the date the signed and dated signature page is returned. The contract term would be from date of receipt of the signature page to September 9, 2023. The Agreement would then be renewed at least 60-days prior to the end of the September 9, 2023 term date by mutual written consent to continue the Agreement for the successive 12-month extension period and the County would send notification of intent to extend the term at that time. Promotion,preservation and protection of the community's health 1221 Fulton Street/P. O. Box 11867, Fresno, CA 93775 (559) 600-3200 • FAX(559)600-7687 The County of Fresno is an Equal Employment Opportunity Employer www.co.fresno.ca.us • www.fcdph.org DocuSign Envelope ID:8FF556B2-9CE5-49DA-86F7-ECC57741DB42 i Al. 1 "Ll Iv1\ 1. 1\CLL11111JG July 1, 2022 Page 2 If CHP chooses to become a party to this Agreement, please sign and date the attached signature page and return it to: Shelly Awes, Staff Analyst Department of Public Health PO Box 11867 Fresno, CA 93775 sawes@fresnocountyca.gov If you have any questions or concerns, please contact Shelly Awes of my staff at (559) 600-6439. Respectfull , avid Luchin', , PHN Director Attachments (2) 2 DocuSign Envelope ID:8FF556B2-9CE5-49DA-86F7-ECC57741DB42 AMENDMENT 1 TO EXHIBIT 1 List of Contractors • Community Medical Imaging (CMI) Community Health Partners (CHP) Sue Kelton, Chief Financial Officer Patrick T. Ramirez, President & CEO 1867 E. Fir Ave., Suite 104 45 River Park Place West, Suite 501 Fresno, CA 93720 Fresno, CA 93720 (559) 325-5809 cramirezmedina@communitymedical.org skelton@cmirad.com (559) 451-3663 Ext. 63663 • Family HealthCare Network (FHCN) • University Faculty Associates, Inc. (UFA) Gary Morrell, Director, Managed Care Marina Montoya, Administrative Assistant, Aryssa Alvidrez, Managed Care Supervisor Patient Account Services 305 E. Center Ave. 2625 E. Divisadero St. Fresno, CA 93721 Visalia, CA 93291 Marina.Montoya@ccfmg.org gwmorrell@fhcn.org / aalvidrez@fhcn.org (559) 453-5200 ext. 11196 (559) 737-4771 / 737-4733 • UCSF Fresno Medical Education Group (UCSF — Central California Faculty Medical Group (CCFMG) Fresno) Marina Montoya, Administrative Assistant, Marina Montoya, Administrative Assistant, Patient Account Services Patient Account Services 2625 E. Divisadero St. 2625 E. Divisadero St. Fresno, CA 93721 Fresno, CA 93721 Marina.Montoya@ccfmg.org Marina.Montoya@ccfmg.org (559) 453-5200 ext. 11196 (559) 453-5200 ext. 11196 • Pathology Associates (PA) Steven J. Frediani, Chief Operating Officer 305 Park Creek Drive Clovis, CA 93611 SFrediani@pathology-associates.com (559) 326-2752 Amendment1 to Exhibit 1 (7/1/2022 SLA) DocuSign Envelope ID:8FF556B2-9CE5-49DA-86F7-ECC57741DB42 1 Community Health Partners (CHP) 2 DocuSigned by: 3 By: F�&nraft- v / 4 Print Name: Patrick T. Ramirez 5 Title: President & Chief Executive Officer 6 Date: 8/4/2022 1 12:51:24 EDT 7 8 9 10 11 12 13 14 15 16 17 Mailing Address: 18 45 River Park Place West, Suite 501 Fresno, CA 93720 19 Contact: Patrick T. Ramirez 20 Phone#: (559) 451-3663 cramirezmedina@communitymedical.org 21 and Contact: Rose Loya, Manager 22 Managed Care Contracts 45 River Park Place West, Suite 501 23 Phone#: (559) 603-7355 RLoya(o-),communitymedical.org 24 25 26 27 Addition to Agreement No. 19-444 Master Agreement for the Provision of Specialty and Primary 28 Professional Medical Services and Emergency Care effective date signed above by CHP -1- DocuSign Envelope ID:8FF556B2-9CE5-49DA-86F7-ECC57741DB42 1 COUNTY OF FRESNO, DEPARTMENT OF 2 PUBLIC HEALTH: 3 4 5 Day' 1 uchini Director 6 7 is ZZ Date: 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 FOR ACCOUNTING USE ONLY: 23 Fund: 0001 24 Org: 5240 25 Account: 7295 26 27 28 -2-