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Malinowski COnsulting/FIRE/19,000/Medicare Ambulance Cost Reporting Malinowski Consulting • Carmel Fire Department-2013 Appropriation#43-509.00; P.O.#24513 Contract Not To Etc eed$19,000.00 ADDITIONAL SERVICES AMENDMENT TO ge"O6Fa AGREEMENT FOR PURCHASE OF GOODS AND SERVICES 4 � 0 THIS AMENDMENT TO THE GOODS AND SERVICES AGREEMENT ("Agreement') entered into by and between the City of Carmel and Malinowski Consulting (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 'IA". Furthermore, the terms of the Agreement shall be amended to include the E-verify requirement as stated in Indiana Code § 22-5-1.7 et seq., which is attached incorporated herein as Exhibit "C". Also, pursuant to I.C. § 5-22-16.5, Vendor shall certify that in signing this document, it does not engage in investment activities within the Country of Iran. 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 Malinowski Consulting by and through its Board of Public Works and Safety By: By: • /Aa sue_— Fames Brainard, Presid. g Officer AuthoryZed Signature Date: / ,tee Ci ��LES / G✓rcK/ Printed Name Mary An :urke Mgmber Date: — ol -L/—/ 3 r/ -s,Pc rr Title Lori S. Watson, M mbea FID/TIN: Date: /&��/1 9 Last Four of SSN if Sole Proprietor: — ATTEST: Date: Nov /9 z0/3 Tana Cordray, ' , Clerk-Treasurer Date: o- - IWI++n.pPlV nb,. nlvn.11,AN9JmM('mnauWdS.o e(-.m S.uY'e�LLpL'OJmfn.w.I k,, 'n6-I}t,NI1 J.'I IFIHV0I\9.1'M11 C i_ , k ' ys CA 4�,�; a " gEL Fire Department Headquarters 2 CIVIC SQUARE CARMEL,INDIANA 46032 317-571-2600 November 8,2013 Charles F.Malinowski Malinowski Consulting 755 West Cannel Drive, Ste.300 Cannel, Indiana 46032 RE: Additional Services#2013-03(P.O.#24513) $19,000.00 Appropriation#509-00 Dear Mr.Malinowski: The City of Cannel has a need for additional professional services and pursuant to our current contract with Malinowski Consulting, contract dated February 20, 2013. I have requested and received from you the proposed scope of services and fee estimates for the following work task: Additional Service: Additional Charges for Medicare Ambulance Cost Reporting Attachment"A" Fee: $19,000.00 Per our contract procedural requirements, I hereby approve this"Additional Professional Services"estimate, and grant you the Notice to Proceed for the above services. PLEASE NOTE: Be advised that"Additional Services"performed on city contracts must be billed separately from the original contract and other additional services. More importantly, the invoice must reference the appropriate Additional Services # and include the P.O. # shown above. Invoices submitted without this information will be returned to your office. Thank you for your continued assistance in providing the City of Cannel with your professional,quality services. If you should have any questions,please give me a call. jaz #c tfully, w F. Hoffm Fire Chief City of Cannel Exhibit ' ` Cc: Mayor James Brainard ' m %Diana Cordray,Clerk Treasurer > ADMENDMENT TO EXISITING AGREEMENT PREPARATION OF MEDICAID AMBULANCE COST REPORTS FOR 2011&2012 Section 1: Introduction The purpose of this amendment is to provide the City of Carmel with a formal proposal outlining how Malinowski Consulting, Inc.can be of assistance in the area of providing technical expertise in the preparation of the a one-time payment adjustment for eligible fee-for-service Medicaid ambulance services. Section 2: Background The City of Carmel Emergency Management Services Division within the Fire Department provides City-wide ambulance services. A significant portion of those services are provided to Medicaid participants. Recently the Federal Office of Medicaid Policy and Planning received approval for a supplemental payment . .• e s - 1 . '.— . . 1. . . 1 • . . i. • .. is - .. .' • . . .. 11 - 1 - .8 - , . q, . •' . i l - ' - 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 2011 and 2012. Section 3: 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 better. • Describe the results of the Ambulance Cost Report to the City of Carmel 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. • 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, EMS Battalion Chief,Mayor,etc.)to review the results of the analysis,focusing on the recoveries to the General Fund. • 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. V"UJ CARMEL,INDIANA-CONTRACT AMENDMENT FOR THE PREPARATION OF AMBULANCE COST REPORTS Section 5: Approach The following approach to this assignment will include these steps: • Schedule an on-site meeting with the appropriate Fire Department staff to collect ambulance specific data for the report. • In cooperation with the City Clerk-Treasurer's Office,determine wages and fringe benefits for the EMS Division. • 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 -----doeurnent.-- - -- --. --- • 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 November 3o, 2013. Section 7: Staffing Malinowski Consulting will utilize the expertise of our Indiana based consulting staff. • Charles Malinowski, President • Barbara Malinowski,Operations Manager • Daniel Vaughn,Consultant • Bruno Afonso,Consultant Section 8: Qualifications The following are key qualifications that make Malinowski Consulting uniquely suited for this assignment: • City of Cannel—Preparation of City-Wide Cost Allocation Plan for 2012. • 2 Indiana Counties—Preparation of Medicaid Ambulance Cost Reports for the years 2011 and 2012. • 21 Indiana Counties-Preparation of County-Wide Cost Allocation Plans for the years 2005 through 2013. • 54 Indiana Counties-Preparation of Title IV-D Monthly Expenditure Reimbursement claims for the years 2004 through 2013. Malinowski Consulting is an Indiana Corporation serving Indiana local government since 2004 with a consulting staff that is based exclusively within Indiana. ePS 3%{ Page 2 CARMEL,INDIANA-CONTRACT AMENDMENT FOR THE PREPARATION OF AMBULANCE COST REPORTS Section 9: Fees and Expenses Proposed Fees: Our fee for this service shall be$9,500.00 for each reporting year/$19,000 in total and is contingent upon the actual recovery of costs from the Federal Government. • The City of Cannel and Malinowski Consulting, Inc.shall share equally in the recoveries up $19,000.00 for each reporting year. Any recoveries above$19,000.00 for each reporting year shall be l00%the City of Carmel's share. • This fee is inclusive of all services performed and no additional expenses will be necessary. • An invoice for the professional service fee will be submitted to the City only after it has received the actual reimbursement from the Federal Government. Section to: Closing It has been a privilege to submit this proposal to the City of Carmel to provide for the preparation of the Medicaid 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. Respectfully submitted, P • Charles F. Malinowski President Page 3 CARMEL,INDIANA-CONTRACT AMENDMENT FOR THE PREPARATION OF AMBULANCE COST REPORTS ACCEPTANCE This agreement between the City of Cannel and Malinowski Consulting,Inc.to provide the preparation of the Medicaid Ambulance Cost Report,the years Ended December 31, 2011 and 2012. The professional fees shall be$9,500.00 for each reporting year/ $19,000 in total and is contingent upon the actual recovery of costs from the Federal Government to the City of Carmel. If the results of the report show that the City is not eligible for the additional payment,Malcon is owed nothing for our services. 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 party may terminate-the-agreement with a thirty-day(3o)written notice. These fees are inclusive of all services performed and no additional expenses will be necessary. An invoice for the professional service fee will be submitted to the City only after it has received the actual reimbursement from the Federal Government and is payable within 45 days. The following signatures will be considered as evidence of the acceptance of the above-described terms. Acceptance by the City of Cannel,Indiana By: Name: Title: Date of Signature: For Malinowski Consulting,Inc. .> • By: Name: Charles F. Malinowski Title: President Pr Page 4 U Malinowski Consulting • Carmel Fire Department-2013 Appropriation#43-509.00; P.O.#24513 Contract Not To Exceed$19,000.00 EXHIBIT`B" E-verify requirement All terms defined in I.C. ¢22-5-1.7 et seq.are adopted and incorporated into this section of the Amendment. Pursuant to I.C. §22-5-1.7 et seq., Vendor shall enroll in and verify the work eligibility status of all of its newly-hired employees using the E-Verify program, if it has not already done so as of the date of this Addendum. Vendor is further required to execute the attached Affidavit, herein referred to as"Exhibit C", which is an Affidavit affirming that: (i)Vendor is enrolled and is participating in the E-verify program,and(ii)Vendor does not knowingly employ any unauthorized aliens.This Addendum incorporates by reference, and in its entirety, attacheCExhibiLC."In_support oLthe_Affidavit. Vendoeshall provide the City with documentation that it has enrolled and is participating in the E-Verify program.This Agreement shall not take effect until said Affidavit is signed by Vendor and delivered to the City's authorized representative. Should Vendor subcontract for the performance of any work under this Addendum, the Vendor shall require any subcontractor(s)to certify by affidavit that: (i)the subcontractor does not knowingly employ or contract with any unauthorized aliens,and(ii)the subcontractor has enrolled and is participating in the E-verify program.Vendor shall maintain a copy of such certification for the duration of the term of any subcontract. Vendor shall also deliver a copy of the certification to the City within seven(7)days of the effective date of the subcontract. If Vendor, or any subcontractor of Vendor, knowingly employs or contracts with any unauthorized aliens, or retains an employee or contract with a person that the Vendor or subcontractor subsequently learns is an unauthorized alien, Vendor shall terminate the employment of or contract with the unauthorized alien within thirty (30) days ("Cure Period"). Should the Vendor or any subcontractor of Vendor fail to cure within the Cure Period,the City has the right to terminate this Agreement without consequence. The E-Verify requirements of this Agreement will not apply,should the E-Verify program cease to exist. �WU.npplWssbl. .Js AWWantea v.n.W.4 S•e*(.-d.S,afl,1kp1.711fl .mds..rn.h.-(H)2017&,I III&!v1110.::AM)