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Malinowski Consulting, Inc/Fire/9,500/Recoup Medicaid Fees Year EndMalinowski Consulting, Inc. Fire Department - 2019 Appropriation # 1120 43-404.00 Fund; P.O. # 102532 Contract Not To Exceed $9,500.00 ADDITIONAL SERVICES AMENDMENT TO AGREEMENT FOR GOODS AND SERVICES THIS AMENDMENT TO THE AGREEMENT FOR GOODS AND SERVICES ("Agreement") entered into by and between the City of Carmel and Malinowski Consulting, Inc., (the "Vendor"), as City Contract dated February 20, 2013 shall amend the terms of the Agreement by adding the additional services to be provided by Vendor consistent with the Scope of Work attached hereto and incorporated herein as Exhibit "A". The terms and conditions of the Agreement shall not otherwise be affected by this Additional Services Amendment and shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have made and executed this Amendment as follows: CITY OF CARMEL, INDIANA by and through its Board of Public Works and Safety By: James Brainard, Presiding Officer Malinowski Consulting, Inc. Authorized Signature Charles F. Malinowski r - ✓ v Printed Name Mary Ann Ike, Memb Date: '� President Lori S. Watson, b Date: a ATT!y$T� Chri ine Pauley, Qgr)Z� reaurer Date: cN / Title FID/TIN: 20-8695464 Last Four of SSN if Sole Proprietor: Date: January 23, 2019 [S^Coave v.�Pro[Sr�: & C.M. S—\Fwr Dgw12019\\9finou.W Con.uliigp 1— ASAda:: 1/16/2019 11:36 AM) malcon MALINOWSKI CONSULTING, INC. January 11, 2019 Chief David Haboush City of Carmel — Fire Department 2 Civic Square — Station 41 Carmel, IN 46032 Re: Proposal — Preparation of Medicaid Ambulance Cost Reports / 2oi8-2o1202 Dear Chief Haboush: Section 1: Introduction The purpose of this letter is to provide the City of Carmel with a formal proposal outlining how Malinowsla Consulting, Inc. can be of assistance in the area of providing technical expertise in the preparation of a payment adjustment for eligible fee -for -service Medicaid ambulance services. Section 2: Background The City of Carmel Fire Department provides ambulance services in and around Carmel, Indiana. Significant portions of those services are provided to Medicaid participants. The Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning received approval for a supplemental payment adjustment to in -state ambulance providers. The payment adjustment is intended to reimburse providers the actual incurred costs of providing ambulance services to eligible Medicaid beneficiaries. The payment adjustment is effective for eligible fee -for -service Medicaid ambulance services provided in 2018, 2019 and 2020. Section g: Objectives The objectives are to: • Provide all necessary documentation to State and Federal program administrators to clearly document related eligible expenses. • Make the process of preparing the Ambulance Cost Report as easy as possible on City employees who can better service the Citizens. • Describe the results of the Ambulance Cost Report to City officials and defend the results to State and Federal program managers or auditors. Section 4: Scope To achieve the objectives of this service, Malinowski Consulting will cover all aspects of the Ambulance Cost Report between the City of Carmel and the State of Indiana. This will include the following: • Ambulance Cost Report Data Collection: Malinowski Consulting will perform all data collection activities. City staff will provide direction as to where the information can be obtained. Exhibit 755 W. Carmel Drive, Suite 203 1 Carmel, IN 46032 TEL317.818.1876 FAX877.346.7986 WWW malconindiana.com CARMEL, INDIANA — PROPOSAL — MEDICAID AMBULANCE COST REPORTS 2018-2019-2020 • Ambulance Cost Report Presentation to City Officials: After the compilation of the Ambulance Cost Report, Malinowski Consulting will meet with the appropriate City Officials (Fire Chief, Mayor, Deputy Fire Chief, etc.) to review the results of the analysis, focusing on the recoveries to the City. • Delivery and Negotiation with State Officials: All delivery, presentations and negotiations with State agencies is included in this service. • Audit Defense to Federal and State Auditors: In the event that State or Federal auditors have questions regarding how the Ambulance Cost Report was prepared, Malinowski Consulting is ready to stand completely behind the plan results. Section 5: Approach The following approach to this assignment will include these steps: • Schedule an on -site meeting with Fire Department to collect ambulance specific data for the report. • In cooperation with the Clerk -Treasurer's Office, determine wages and fringe benefits for the Fire Department. • Review City expenditure claims from the General and other Funds to ensure the utmost recoveries of eligible supplies and other services and charges. • Compile all data collected from various City departments into an electronic format that will generate the appropriate report that meets State and Federal guidelines. • Review the Ambulance Cost Report with City staff to foster an understanding of the submitted document. • Deliver the Ambulance Cost Report to the responsible State agency contact guaranteeing receipt of all required data. • Monitor the approval and payment process by the State. • Respond quickly to questions posed the Indiana Family and Social Services Administration, Indiana State Board of Accounts and Federal program managers and auditors. Section 6: Timing The Ambulance Cost Reports will be prepared and submitted to Indiana FSSA by the Federal filing deadline of May 31m, 2019, 202o and 2021. Section 7: Stq ing Malinowski Consulting will utilize the expertise of our Indiana based consulting staff. • Charles Malinowski, President • Barbara Malinowski, Operations Manager • Daniel Vaughn, Senior Consultant • Matthew Lowery, Consultant Exhibit 755 W. Carmel Drive, Suite 203 1 Carmel, IN 46032 C TEL 317.818.1876 FAX 877.346.7986 www malconindiana.eom Page 2 C;` y CARMEL, INDIANA — PROPOSAL — MEDICAID AMBULANCE CosT REPORTS 2oi8-2o19-2o2o Section 8: Qualifications The following are key qualifications that make Malinowski Consulting uniquely suited for this assignment: • Over 18 Indiana Counties, Cities/Towns/Townships, Fire Territories - Preparation of the annual Medicaid Ambulance Cost Report for the years 2011 through 2018. • Over 20 Indiana Counties - Preparation of County -Wide Cost Allocation Plans for the years 2005 through 2018. • 1 Indiana city — Preparation of City -Wide Cost Allocation Plan for 2012. • Over 50 Indiana Counties - Preparation of Title IV-D Monthly Expenditure Reimbursement claims for the years 2004 through 2018. Malinowski Consulting is an Indiana Corporation exclusively serving Indiana Local Government since 2004 with a consulting staff that is based within Indiana. Section 9: Fees and Expenses Our fee for this service will be $9,500.00 for each year the reports are prepared. This fee is fixed and payment is not contingent upon actual recovery of costs from the Indiana Family and Social Services Administration. • An invoice will be issued to the City when the City receives "Final Notice of Program Reimbursement" from the Indiana Office of Medicaid Policy and Planning and is payable within 45 days. • This fee is inclusive of all services performed related to this project including: o Data Collection, o Report Presentation to City Officials, o Delivery and Negotiation with the Indiana Office of Medicaid Policy and Planning. • Audit defense fees after the "Final Notice" has been issued will be billed at the rate of $175.00 per hour at the discretion of Malcon. The City will have ultimate approval on accepting the invoice for audit defense. This invoice is payable within 45 days. Section lo: Closing It has been a privilege to submit this proposal to the City of Carmel to provide for the preparation of the Ambulance Cost Reports. The comprehensive approach outlined above will optimize recoveries from the State and Federal governments, meet and exceed filing guidelines and substantially enhance the reliability and defense of the Ambulance Cost Report. If this proposal meets with your approval, please have the appropriate City official sign in the acceptance section and return one signed copy. Respec bmitt , Charles F. Malinowski President Exhibit 755 W. Carmel Drive, Suite 203 1 Carmel, IN 46032 TEL 317.818.i876 FAX 877.346.7986 www malconindiana.com Page 3 v� CARMEL, BmiANA— PRoPosAL—MEDICAIDAMBULANCE CosTREPORTs 2018-2019-2020 ACCEPTANCE This agreement between The City of Carmel, Indiana and Malinowsid Consulting, Inc. to provide the preparation of the Medicaid Ambulance Cost Reporting, the years Ended December 31, 2o18, 2019 & 2020. The fee for this service will be $9,5oo.00 for each year the reports are prepared. This fee is fixed and payment is not contingent upon actual recovery of costs from the Indiana Family and Social Services Administration. • An invoice will be issued to the City when the City receives "Final Notice of Program Reimbursement" from the Indiana Office of Medicaid Policy and Planning and is payable within 45 days. • This fee is inclusive of all services performed related to this project including: o Data Collection, o Report Presentation to City Officials, o Delivery and Negotiation with the Indiana Office of Medicaid Policy and Planning. • Audit defense fees after the "Final Notice"has been issued will be billed at the rate of $175.00 per hour at the discretion of Malcon. The City will have ultimate approval on accepting the invoice for audit defense. This invoice is payable within 45 days. This agreement shall be in effect from the date of signature, entered below, until either party wishes to change the scope of the services or the professional fee. Either parry may terminate the agreement with a thirty -day (30) written notice. The following signatures will be considered as evidence of the acceptance of the above -described terms. Acceptance by the City of Carmel, Indiana By: Name: Title: Date of Signature: For Malinowsld , Inc. By. Name: Charles F. Malinowsld Title: President Exhibit A- 755 W. Carmel Drive, Suite 203 1 Carmel, IN 46032 TEL 317.818.1876 FAX 877.346.7986 www malconindiana.com Page 4 �f City ®f Carmel INDIANA RETAIL TAX EXEMPT CERTIFICATE NO.003120155 002 0 Page 1 of 1 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 102532 ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ONINVOICES, AIP CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 1/14/2019 366749 Medicaid Ambluance Cost Reporting 2018 MALINOWSKI CONSULTING INC Fire Department VENDOR 755 W CARMEL DRIVE STE 203 SHIP 2 Civic Square TO Carmel, IN 46032- CARMEL, IN 46032 - PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 32977 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 1120 Account: 43-404.00 1 Each Send Invoice To: Fire Department 2 Civic Square Carmel, IN 46032- DEPARTMENT Fund: 101 General Fund Recoup Medicaid Fees Year End PLEASE INVOICE IN DUPLICATE ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT $9,500.00 $9,500.00 Sub Total $9,500.00 SHIPPING INSTRUCTIONS 'SHIP PREPAID. 'C.O.D. SHIPMENT CANNOT BE ACCEPTED. 'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL `THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1W AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY TITLE CONTROL NO. 102532 CLERK -TREASURER PAYMENT $9,500.00 ' AIP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. Denise Snyder James Crider Budget & Accreditation Manager Administration