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Home My WebLink AboutMedicaid Administration Agreement 2018GUARANTEED SCHOOL-BASED COMPLIANCE MEDICAID ADMINISTRATION AGREEMENT This Agreement is made by and between Compltance Services Aaaoc:latlon, Inc., an Idaho General, located at 6003 W Overland Rd, Suite 201, Boise, ID 83709, ~reinafter referred to as CSA, and Bonnevflle School Ofetrlct #93, looated al :!1497 N Ammon Rd., Idaho Falls, ID, 83401, hereinafter referred to ae the SCHOOL DISTRICT. WHEREAS, CSA is an Idaho corporation organized to provide COMPLIANT ; MEDICAID administration to Idaho schools, and has developed a complete ! . ~ COMPLIANT MEDICAID administration program which provides Idaho school dletrlcts with training, administrative, consultatlVe, statlllttcal, audit services, and a guarantee of .compliance; WHEREAS, the SCHOOL DISTRICT Wishes to obtain. and CSA wish ea to furnish these COMPLIANT MEDICAID administration services; NOW THEREFORE, In consideration of ttle premises and the mutual promises and undertakings ofthe parties hereinafter set forth, the parties h&reby agree aa follows: I. The term of the Agreement shall be from July 1, 2018 to June 30, 2023. 2. CSA will provide COMPLIANT MEDICAID administration ••rvlcea H outlined In the SUMMARY OF MEDICAID ADMINISTRATION SERVICES (Attachment A} document attached. 3. The SCHOOL DISTRICT agrees to perform the COMPLIANT MEDICAID administratlon services as outlined In the SUMMARY OF MEDICAID ADMINISTRATION SERVICES (Attachment B) document attached. 4. As consideration for the provision of said se1vloes, the SCHOOL DISTRICT ahall pay CSA an administration fee of 6% for all MEDICAID reimbursements r&cet...ed either by direct deposit, checks. orwhen payment Is made available to the SCHOOL DISTRICT by the Idaho Department of Health & Welfare pending match payment. Page I oU GUARANTEED SCHOOL-BASED COMPLIANCE MEDICAID ADMINISTRATION AGREEMENT a) The administrative fee Is payable upon receipt of eaoh Invoice whloh will accompany the fully recunoilecl remittance report. b) The guarantee is renected In a service level 11greemanl and wlll lnclucle (Attachment A-Attachment B): • Idaho DHW School-Based S8Nh:as Medicaid Prosram oompll1nc1. • IEP monitoring for guarant11ed aubmlnlon of Medicaid ol1lm1. NO monitoring for student or provider quall!!oetlona. CSA Wlll oredlt •II additional audit penallles reaultlng In SBS Medlt:ald bllllng audlta and credit all adminiatratlon fees aaeoc:lated with any recouped 1mount1. No guarantee fer IDEA compliance. • iTracklEP software. Biiied yearly at the etete rotmburaabla rate. No addiUonal c:ost to tha district. ("Opt IN") • lTrackLOGS. Provided at no extra cott, ("Opt IN") • Physician referral. Provided at no extl'lt <:.ott. (Muet "Opt IN") GUARANTEE WILL NOT INCLUpE: • Monitoring of IDEA quallfy!ng doouMentatlon, H1Vfc:11 provided, or documentation of &ervlces provided In ac:hoola. • Monitoring of 'no ac:hool" days or alud~ml absent daya. • Monitoring of; hiring, quellflcatlona and/or MGdlcald oxolualon llat, of providers of seNlces In echoole. Added Value Services provllied jo lhla agrument: (Check one box, eech tine) "Opt IN" "Opt our Assisting with obtaining Signed Physician referrals t} 0 Use of iTracklEP -onllne IEP Software (Attachment D) Ji' 0 Use of iTrackLOGS -onllne date tracking module :zl. bl c} The Administrative Fee la u follows : 5% l'n110 2 of 8 GUARANTEED SCHOOL-BASED COMPLIANCE MEDICAID ADMINISTRATION AGREEMENT 5. The parties hereIn covenant and agree to review the Idaho Medlcald Provider Handbook, Rehabllltatlve and H1alth Related Sarvlce and both partlH herein covenant and agree to abide by the terms contained therein and 1ub1equent orders and or directions as the Idaho Department of He•lth and Waifam 1hall provide in reference to ihe Idaho Medicaid Provider Handbook. Both partlH herein acknowledge that they have a current copy of the above rsferencl!ld handbook In their possession. 6. Both parties herein acknowledge and agree that the Information 11.111ubmllted by CSA to the Idaho Department of Health and Welfare is Information provided lo CSA fl'om the SCHOOL DISTRICT through the IEF>'e and phyalclan referral1. Anv errors or omissions for services or bllllng documentation ofthoae aervlcee provided In schools, whether or not reflected on the lEP or p~yalclan ,..ferral, may result in overpayment c.r underpayment, therein may affect and oause Medicaid adjustments. SCHOOL DISTRICT acknowledges that the l(l()Uracy of any Medicaid b!Hings submitted by CSA are dependent c.n Ill• aoouracy of lnfonnatlon provided to CSA by SCHOOL DISTRICT. CSA does not and Will not guarantee errors or omissions for providing documented eervletis or th& blllll\g documentation of those services. For aervlces provld1d, documentation of ltloa& services and IDEA compliance, SCHOOL DISTRICT releases and holds harmless CSA, its officers and agents, from any and all ll1blllty·to lht Idaho· Department C>f Health and Welfare, Medicaid or any othe1•governmental or private person or entity for any overpayments, acljuatmenta, demand• tor repayment, interest, penalties of other clalms of any sort related to any sorvloaa provided by CSA, Including Without !Imitation any Medicaid bllllnga submitted by CSA or SCHOOL DISTRICT. 7. The SCHOOL DISTRICT herein acknowledges and agrees that CSA 11 providing a service to the SCHOOL DISTRICT that ia 1peclllllzed and that In the implementation of this service CSA has trained SCHOOL DISTRICT agent• and has provided SCHOOL DISTRICT agents with proprietary knowledge and Information that sala agents would not otherwise obtain. Tharefore, SCHOOL DISTRICT f\ereln acknowledges end agree8 that during tha term ofthls agreement the SCHOOL DISTRICT or Ila agents will not uae, oonault with, hint, retain, oro1herwlse cau88 a11y agent ofSCHOOL DISTRICT, be II a SCHOOL. DISTRICT employee, agant or Independent con1raetor, or any other peraon or entity, to submit Medicaid billings or otherwise compete wllh th• HNlees ll provided by CSA lo SCHOOL DISTRICT and SCHOOL DISTRICT wlll not Independently submit claims to Medicaid or ceuee an agent or any othar peraon or entity to submit such clalms, encl ahall not circumvent CSA ln any other fashion, directly or Indirectly. SCHOOL DISTRICT fUrther agree11 that It will not disclose any proprietaiy or other tnformallon providad to II by CSA to any other person or entity, wlll only aUow such uee of auch lnformaUon by Its agents aa necessary to perform the terms of this agreement. and wlll return all eoplaa of Pa"e3 ors GUARANTEED SCHOOL-BASED COMPLIANCE MEDICAID ADMrNISTRA TION AGRJ£EMENT any such Information to CSA at the termination of this agraernfnt. SCHOOL DISTRICT agrees that in the case of any attempt to terminate this agl'Hm&nt before the end·ot the term, or any &ubtnlsslon of any Medicaid bllllng{•) performed by SCHOOL DISTRICT or any other person or entity on Ila behalf, SCHOOL DISTRICT shall account for all such iUbmisalons and ah1!1 owe CSA the above-stated (Section 4(o)) administrative tea for all auoh wbmlt1lon1. SCHOOL DISTRICT also acknowledges and agrees not to dl1cloH ap1clal1Hd information and knowledge leamed through CSA, to other achoo! district& or their agents, or any other person or entity, via written or verbal communloaUona. Such dfscfosure is a material breach of this agreement. 8. SCHOOL DISTRICT, by executing this agreement, warranta that tho par1on signing this agreement has the authorl1y to do eo, ao ae to bind SCHOOL DISTRICT to its terms, and that all nece8ial)' meetings, approv1le, authorizations, I/Oles and other matters neceuary to mak.e this a valld and enforceable agreement binding SCHOOL DISTRICT have been ccmplaled, finalized and pel'formed. 9. Thlt> agreement represents Iha entire agreement ofthe parties and can be modified only by a writing si9ned by both parties. No prior verbal promlaaa, or agreemenai not contained herein are vend. This agraament sl\aHbe Interpreted and enforced under the laws of the State of Idaho. In the event of lltlgatlon arlstne out of an alleged breach ofthis agreement, the prevailing party ahall be tntlllsd to oosts and attorney fees Incurred. Png•4o£ 8 GUARANTEED SCHOOLMDASED COMPLIANCE MEDICAID ADMINISTRATION AGREEMENT IN WITNESS THEREOF, the parties have signed this AgrHment. CSA: Compliance Services Association, Inc. Date: Celeste Blackburn, SBS Program Director SCHOOL DISTRICT: Bonnevllle ·School Ola!rlct #93 Data: 8/qf/8 Print ~Mp l& (Duly Authorized Agent) GUARANTEED SCHOOL-BASED COMPLIANCE MEDICAID ADMINISTRATION AGREEMENT Attachment A Summary of Guaranteed school-baaed oompH•nce Medicaid Administrative SeNl011 As the guaranteeing oonsultlng and billing agent CSA agreH to adhere to 11! rulea and regulations that govern the submitting of claims under the Ruloa and Regulations that govern the school-based Rehabllltatlve and Health Related Services Program. Below Is a list of services and reaponslbllltles that CSA agree• to dellver: • Guaranteed School-based services Medicaid compliance, admlnlatreliw, consulting, audit services, to the SCHOOL DISTRICT. Guarantee baaod on information documented on the JEP and Physician referral. CSA wlll pay all additional audit penalties resulting In SBS Medicaid blllfng audit$ and oradll llll administration fees for the recouped am0unt. Exclud ing aott.ial reeoupmenta. N1:1 guarantee for IDEA compllance. • Monitoring of; Student quallflcatlons and aneumentalav1lu11t1on1 that wlll be completed at the school and eent to CSA upon completion. • State and federal Medicaid lnformatlon, llalaons, and updatea: timely and accurate Information regarding the rules and regulatlona asaoclated With the Rehabilitetive and H&Blth Re/sled S&rvlces Program • Assistance with resean::h and eventual identification of the SCHOOL OISTRICT Medicaid ellglbte population • Reasonable efforts in securing physician's referrels (Attachment C) • Upon request, on-site and.web training and Instruction for Ac!mlnl1trators, health· related professionals, paraprofessionals, and aides • Guaranteed, Accurate, dependable, and confidential Sllllng ProceH. Traoklng and Reconciliation of all submitted clalm1 • Access to onllne service dellvery11oftware and AdmlnlstrallV8 Niportlng toola • Customized reports showing the status of all Medicaid tran&actlona and reimbursements • Data warehousing and digital archival of School Obtrlct bllllng lnformaijon, submitted claims, service records, adjustment deta.lls, and &Lldlt lnform1ll0i1 • Assistance in Audtt Readinesa preparation and feellltatlon to ensure proper procedure and compliance; Interface with the Department of Health and Welfart es appropriate for audit flndlngs GUARANTEED SCHOOL~BASED COMPLIANCE MEDICAID ADMINISTRATION AGREEMENT Attac;hment B School Olatrlct Responsllllllttu As the Provider of Record, tl1e SCHOOL DISTRICT agreea to provide lnformatltin to CSA that adheres to all Rules and Regulations that govern the School·bH•d Rehabllltattve and Health Related Services Ptogram. Below la a I/st of aervlcea and responsibilities that the SCHOOL DISTRICT agrees to perform: The SCHOOL DISTRICT is reeponalble for the foll owing: • Insure that; One-time Paren1al consents are algned, Primary Cara physician notifications requirements are met, atudente qualify for aerv1c1s Hated on the IEP, all·services listed on the IEP and Physician referrals are performed end documented by qualified personnel, that all services and documentation la In accordance with IDEA, and that the compliant billtng documentation I& aoourate with th&documented services listed on the IEP aAd Physician referrals. • Insure that qualified personnel complete and submit timely 11nd accuralei IEP cover page and service page, amendments, seivlc:e delivery logs (racorde) that meet Medicaid requirements for documenting service delivery and for which the SCHOOL DISTRICT is seeking reimbursement and to submit $UCh records lo CSA via paper claims or web-based software provided by CSA, 110 that CSA rn1y provide timely and accurate Medicaid claims and reporting for the dl11trlot. • Insure that certifications and llcensures of ell praotlllonara are aoourato snd UP· to-date. Insure that all practitioners submitting claim• are not dlsquallf!ad to do ao by the Department of Health & Welfare or the Center for Medicare and Mti<lloald Services (CMS). Maintain neoeasary paperwork related to certlf!oallona, licens.ures, etc. of ell qualifled staff inoJudin; contracted aervlaell for whoat services the SCHOOL DISTRICT Is seeking relmburli!ement • Maintaln all Individual Education Programs (lePs) acoordlng to Rahtb/Utah've tlfld Health Related SeNlces program guidelines for all services for whloh the SCHOOL DISTRICT Is seeking Medicaid relmbul'!ement. Provide CSA with th& IEP cover page and service page and am1ndment9. • Maintain on file and provide CSA with coplee of an recommendetlone or referral& from a physician or other practitioner of Iha healing arts for servloea for Which th& SCHOOL DISTRICl ie seeking reimbursement. Png• 7 of 8 GUARANTEED SCHOOL-BASED COMPLIANCE MEDICAlD ADMINJST.RATION AG.REEMEN't Attachment C Physicians Referral In the event that the SCHOOL DISTRICT doea "Opt IN" to have CSA provide BHlattlnllit in obtaining physician referrals as part of the contractual arrangement·th• following applies: • CSA will monitor physician referrals for all students for which the SCHOOL DISTRICT Is submitting Medicaid claims. No claims will be aubmltted without insuring that a timely referral has been obUltned by the SCHOOL DtSTRlCT for the services lclentlfled in the student's IEP. CSA wtll coordinate the r•fetral process with the SCHOOL DISTRICT and make reasonable efforts to obtain a referral on behalf of the SCHOOL DISTRICT. • When CSA has exhausted reasonable means, CSA Wiii notify the SOHOOL DISTRICT of the names ofthe students for whom a referral wae not obtained along with the reason why. • CSA will maintain and archive referrals from a physician or other practlllonar of the healing arts for services forwhleh the SCHOOL DISTRICT aaaka reimbursement. Attachment C ITracklEP SoftWare Solution • No cost to SCHOOL DISTRICT. rrracklEP costs are limited to the atate reimbursement amount for !EP software, Free data atorage, Fl'ff update11, Fl'IHI training, Free form creation and upgrades . • CSA, Inc. utilizes ''proprietary software" end Its accompanying d11tabase ayatem for processing, storing, and retrieving all Medicaid Biiiing Reoerde. Thia 1y1t&m has been optimized for the Idaho Medicaid sohool-baeed servloea program, Including data collecUon and alectronlc transmission requlrementa, and provldai accurate billing services to participating Idaho School Dlalf'lota,