HomeMy WebLinkAboutAgreement A-15-150 with CA Dept. of Health Care Services and Madera County Office of Education.pdf!
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MAY u 4 2015
1 NOVATION AGREEMENT
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3 This novation agreement Is dated April 21 , 2015, and Is between the
4 COUNTY OF FRESNO, a Political Subdivision ofthe State of California ("COUNTY'~, the
5 STATE OF CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES ("DHCS"), and the
6 MADERA COUNTY OFFICE OF EDUCATION whose address Is 1105 S. Madera Ave., Madera
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7 CA 93637 ("MCSOS").
WITNESSETH: B
9 WHEREAS, COUNTY, on May 22, 2012, entered Into an agreement with DHCS to
10 perform School-Based Medi-Cal Administrative Activities {SMAA), which Is DHCS agreement
11 number 12-89005 and COUNTY agreement number 12-122 ("Original Agreement"); and,
WHEREAS, COUNTY, In its desire to perform SMAA contracted with various Local
13 Education Agencies (LEA) including those listed on Attach~e,\)t A to this agreement; and,
WHEREAS, the Centers for Medicare and Med& Services (CMS) performed a
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15 financial review of the California SMAA program and in June of 2012 placed into state-wide
16 deferral all SMAA invoices claimed on the December31, 2011 CMS-64 and all other SMAA
17 invoices subsequent to those claimed on the December 31, 2011 CMS-64 until adequate
18 documentation could be provided to show that the claims comply with Federal Medicaid
19 administrative claiming requirements; and,
20 WHEREAS, in order to demonstrate compliance with Federal Medicaid
21 administrative claiming requirements, on October 28,2013, a Reasona~leness Test Criteria
22 (RTC) was Implemented by DHCS and CMS to be applied state-wide to all deferred SMAA
23 Invoices including those Identified in Attachment A; and,
24 WHEREAS, on September 17, 2014, DHCS in conjunction with CMS suspended
25 the RTC process and replaced it with a process that will use future Random Moment Time
26 Survey (RMTS) guidelines and results in order to reconcile the deferred SMAA invoices,
27 including those listed on Attachment A ("Outstanding Invoices"), to Federal Medicaid
28 administrative claiming requirements; and,
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WHEREAS, on June 4, 2013, COUNTY terminated its Master Agreement with the
LEA's whereupon the LEA's contracted with MCSOS, which is the lead agent for the Madera
Local Education Consortium (LEG); and,
WHEREAS, COUNTY has announced its intention to no longer participate in SMAA
and has chosen not to join the Local Government Agency (LGA) SMAA Consortium and will
therefore not have access to RMTS results for the purpose of reconciling the Outstanding
Invoices; and,
WHEREAS, MCSOS, has agreed to accept responsibility for the Outstanding
Invoices for the purpose of reconciling to Federal Medicaid administrative claiming
requirements; and,
WHEREAS, COUNTY and MCSOS, are entering into this novation agreement in
order to ensure the reconciliation of the Outstanding Invoices to Federal Medicaid
administrative claiming requirements and the revision/correction, review, and submission to
DHCS of the Outstanding Invoices so that the LEA's may receive payment for services
rendered; and,
NOW, THEREFORE, in consideration of their mutual covenants and conditions, the
parties hereto agree as follows:
1. NOVATION
COUNTY, DHCS, and MCSOS expressly consent to a novation by which
COUNTY is discharged of all rights and obligations under the Original Agreement as to the
Outstanding Invoices, and MCSOS assumes all rights and obligations of the "Contractor" under
the Original Agreement as to the Outstanding Invoices.
2. OBLIGATIONS OF MCSOS
A. From the effective date of this novation agreement and through the
termination of the Original Agreement, MCSOS shall be responsible for all obligations, and have
all rights, of the "Contractor" under the Original Agreement as to the Outstanding Invoices,
including but not limited to the revision or correction, reconciliation, review, and submission of the
Outstanding Invoices.
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B. MCSOS shall take all steps reasonably necessary to revise or correct,
reconcile, review, and submit the Outstanding Invoices in accordance with all applicable federal
and state law, regulation, policy, and procedure including those issued by DHCS.
C. MCSOS shall receive and disburse all reimbursements, including any
interim payments received, in connection with the Outstanding Invoices.
D. After revising those Outstanding Invoices that have been paid,
MCSOS shall collect from LEA's and forward to DHCS any overpayments resulting from the
revision of those invoices (Welf & I nst. Code Sections 14176 and 14177).
E. MCSOS shall accept all risk, including audit risk, resulting from the
obligations that it assumes under this agreement, and shall hold COUNTY harmless against
and indemnify COUNTY for all losses (including all claims, causes of action, demands,
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12 liabilities, damages, costs, expenses including attorney fees and costs, and all other losses of
13 any kind) to the COUNTY, to MCSOS, or to any other person, entity, or government agency,
14 that result from performance by MCSOS of the obligations that it assumes under this
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agreement.
3. OBLIGATIONS OF THE COUNTY
A. COUNTY shall provide to MCSOS all information in COUNTY's
possession that is reasonably necessary for MCSOS to revise or correct, reconcile, review, and
submit the Outstanding Invoices.
B. COUNTY hereby releases its claim to any uncollected fees that may be
due to COUNTY from LEA's under the Outstanding Invoices. The maximum amount payable
by COUNTY to MCSOS under this novation agreement is zero dollars ($0).
C. COUNTY shall transfer to MCSOS all funds received by COUNTY in
payment, including interim payments, for the Outstanding Invoices that are as yet unpaid.
4. OBLIGATIONS OF DHCS 25
26 A. DHCS hereby consents to COUNTY's and MCSOS's request to transfer
27 from COUNTY to MCSOS all rights and responsibilities of the "Contractor" under the Original
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1 Agreement for the Outstanding Invoices .
2 B. DHCS hereby recognizes MCSOS as the responsible entity, and the
3 "Contractor" under the Original Agreement, as to the Outstanding Invoices.
4 C. DHCS shall ensure that reimbursement payments, including any interim
5 payments, payable on the Outstanding Invoices that were submitted on COUNTY letterhead, will
6 be forwarded to MCSOS.
7 5. MODIFICATION
8 This novation agreement may not be modified except by a separate written
9 agreement signed by COUNTY, MCSOS, and DHCS.
10 6. GOVERNING LAW
11 Venue for any action arising out of or related to this novation agreement shall
12 only be in Fresno County, California. The rights and obligations of the parties and all
13 interpretation and performance of this novation agreement shall be governed in all respects by
14 the laws of the State of California.
15 7. SEVERABILITY
16 If anything in this novation agreement is found by a court of competent
17 jurisdiction to be unlawful or otherwise unenforceable, the balance of this agreement remains in
18 effect.
19 8. HEADINGS
20 The descriptive headings and section titles in this agreement are for
21 convenience only and are not part of this agreement.
22 9. COUNTERPARTS
23 This novation agreement may be signed in counterparts, each of which is an
24 original, and all of which together constitute this novation agreement.
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1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
2 the day and year first hereinabove written.
3 COUNTY SUPT. OF SCHOOLS
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Geri Kendall Cox
Print Name & Title ATIEST: 6
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Chief Business and Administrative Services Officer BERNICE E. SEIDEL, Clerk
Board of Supervisors
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1105 South Madera Ave.
Mailing Address
Madera, CA 93637
DATE: March 18, 2015
14 APPROVED AS TO LEGAL FORM
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County Counsel
16 (iofA,/y~ Fre.I~)
17 DHCS
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(Authorized Signature)
Print Name & Title
Mailing Address
DATE:
FOR ACCOUNTING USE ONLY:
ORG No.: 041 00300
Account No.: ~ 7bl9.J
Requisition No.: None
FCMC 06/11
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By ~\~&~Of
Deputy
DATE:
REVIE4~0M~OR APPROVAL
Department Head's Signature
APPRT..D AS TO A)X10UNTING FORM
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Auditor-Controller/Treasurer-Tax Collector
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
the day and year first hereinabove written.
Gex~ Kendall Cox
Print Name & Tttle ATTEST:
Chief Bu8~ess and Administrat~ve Sexviees Officer BERNICE E. SEIDEL, Cieri<
Board of Supervisors
1105 South Madera Ave_
Mailing Address
Madera, CA 93637
DATE: March 18, 2015
APPROVED AS TO LEGAL FORM
J oh" M e"duu... Ch..e ~ .SNfD
Print Name & Title
I';) o I C c p du \, ft.u\l.,.. '3 o '2. 7
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Mailing Address
DATE: {.,/ 2-/2-uiS
FOR ACCOUNTING USE ONLY:
ORG No.: 04100300
Account No.: ,1A6tT" 7$19.5'
Requisition No.: None
FCMC 06/11
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By .s.u.s.o,..) l¢>&sh~
Depty
DATE:
REVIE.4~0M~OR APPROVAL
Department Head's Signature
APPRO ED AS TO A~NG FORM
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
the day and year first hereinabove written.
Geri Kendall Cox
Print Name & Title ATol'EST:
Chief Business and Administrative Services Officer BERNICE E. SEIDEL, Clelk
Board of Supervisors
llO.'i South Madera Ave.
Mailing Address
Madera, CA 93637
DATE: March 18, 20l.'i
J ~\-)"' M-t.,_du...._ 'C .. ht.e.f., SIVFI)
Print Name & Title 1
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Mailing Address ' ....
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DATE: {.p /2.1 2.-0 I 5
FOR ACCOUNTING USE ONLY:
ORG No.: .· 04100300
AccountNo.: :LA-61l' 7~95'
Requisition No_.: None
FCMC 06/11
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By ,O,us !Me.) jl,jghZ£y
Dep
DATE:
Department of Health Care Services
Director's Office
P.O. Box 997413
1501 Capitol Avenue, MS 0000
Sacramento, CA 95899-7413
1 Attachment A
2 Local Education Agency
3 Invoice Fiscal Year/Quarter Revise (R) I Correct (C)
4 Central Unified School District
2009/10-4 R 5 2010/11-1 R 2011/12-1 R
6 2010/11-2 R 2011/12-2 R
2010/11-3 R 2011/13-3 R
7 2010/11-4 R 2011/12-4 R
8 Clovis Unified School District
9 2009/1 0-4 R
2010/11-1 R 2011/12-1 C
10 2010/11-2 R 2011/12-2 C
11 2010/11-3 c 2011/13-3 c
2010/11-4 c 2011/12-4 c
12
Firebaugh/Las Deltas Unified School District
13 2009/1 0-4 R
14 Kings Canyon Joint Unified School District
15 2009/1 0-4 R
2010/11-1 R
16 2010/11-2 R
17 2010/11-3 c
2010/11-4 c
18
2011/12-1
2011/12-2
2011/13-3
2011/12-4
Selma Unified School District
c
c
c
c
19 2011/12-1 c
20 2010/11-2 R 2011/12-2 C
2010/11-3 R 2011/13-3 C
21 2010/11-4 R 2011/12-4 C
22 West Hills Community College
23 2010/11-1 R 2011/12-1 C
2010/11-2 R 2011/12-2 C
24 2010/11-3 c 2011/13-3 c
25 2010/11-4 c 2011/12-4 c
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