ORDER NO. :1830]_ MOTION TO APPROVE MANDA.TFD PROVIDER AGREEMENT On this the 12th day of December 1988, upon motion made by Commissioner Holland, ser,ondeci by Commissioner Ray, the Court unanimously approved the mandated provider agreement between G. L. Mabaquiao, M.D. and the County of Kerr and authorized County Judge Danny R. Edwards to sign the contract on behalf of the County, effective December 12, 1988 ~r~~ C..._.__ 5:~ , ..:., r'. ,'?=' '`:FETi' ~ Ai;.:.:F:1 Pir'~CEST 1•~.~-:; ;;~_ FRED HOLLAtiU ~, L A,,.~: CO COMI~4. - PREC. 1 ~'~ " -• - DECEMBER 12, 1988 =••- - ----•--- ^-- - ~ --- CO\SIDERATIOI~ OF 1~4ANDATED COtiTR.-ACTOR PROVIDER CO'~TRACT. . f:.., ... ...."> .. ,i"iiif:iZ :'~"f. 5 ,~ [~C'~,'E: 1 I)„'~ S :FOi~r. ~..i.TT":i; IF 1":,....R;,[;I.E, .1 (;f:...:1 Ria;? ..STS ...'~`.' ?'.. .,.`.T)I`. +1ti ('rFI Ic',. S'IA':'I~`:cRY k"T1i `iliE :1F,t~`.'„ l.:r(?i..:1"iIr':. t•.!•}ii.. . .. "i:ST rc.CF:I'.'ED BY: TH TS IL"r,nl E;S i ~? i•:('?•:I': f~.il Oti : ~~ :1.1.1. - P ". ~1LL ArF.'\T):1 REOLT•:STS IJII,T, BE SCRF.ENGU BY THE COUNTY TL"UGF'S OFFICE TO DETFR`tINF. IF t~i)I-:- OUA'! i~ i':FOR.'`I~1TI01I H:1S BrI::: t RF.P:'1KED FOR TiIF. COURT'S FOR`L1L CO"JSiliERATIOti IIVD :'~C"; IO:~ :AT i i?~f;- ijF COliRT MEETINGS. ~'nliR C"OPER:ITIO"+ (JILL BF. APPRECIt1TED A*:D GONTRIBL'TE TO[.:1P.1)S `iiii:F. REQUEST BT>ZNG ADDRESSED ,'1T THE EF+RLIEST OPPORTL'NTIY. . I 1' ,~ ~~ ,a i-; ; .a 4 ~` ~~. tlt i ~ "'1 ~ '~ , a+. i. _ ~ AGREEMENT (PHYSICIAN -GENERAL) This Mandated Provider Agreement is entered into on the 12th day of December 1988, by and between G . L . MABA UTAO , M . D . _______________ (hereinafter called "Physician", whether one or more), and KERB COUNTY, TEXAS, acting by and through its duly authorized COUNTY JUDGE, DANNY R. EDWARDS, as authorized by the Commissioners Court of Kerr County, Texas (hereinafter called "County"). WITNESSETH WHEREAS, County is required by the Indigent Health Care and Treatment Act (herein "Act") to provide certain Physician services for its eligible residents; WHEREAS, County desires to insure that County's eligible residents receive those mandatory physician services required by the Act; WHEREAS, Physician agrees to provide, or to arrange the provisions of, those mandatory physician services required by the Act for County's eligible residents; NOW, THEREFORE, in consideration of the mutual covenants herein contained County hereby designates and Physician hereby agrees to be a Mandated Provider for mandatory physician services required by the Act or the Act's regulations to be provided to County's eligible residents and the parties agree as follows: 1. DEFINITIONS All terms shall be as defined by the Act and by the TEXAS DEPARTMENTOF HUMAN SERVICES, (herein "Department") to the extent of the departments rights, responsibilities and powers under the Act. 2. MANDATED PROVIDER Physician shall be a mandated provider of the mandatory physician services for County's eligible residents, as defined by the Act. Physician represents that Physician is duly licensed as a Medical Doctor under the laws of the State of Texas and is certified for the Medicare program by 1 the IIealth Care Financing Administration. Unless otherwi ayreed upon, Physician shall deliver, or arrange to ,e livered, Physician services that are considered mandator services pursuant to the Act or as defined by the Department. Such services shall be provided to eligible residents of County who do not reside within an area that a public physician or physician district has a legal obligation to serve. County shall require its eligible residents to obtain mandatory physician services from contracting Physicians except in emergency situations, or when medically inappropriate. 3. COUNTY'S FINANCIAL OBLIGATIONS County shall reimburse Physician for physician services provided to eligible residents. County will reimburse Physician for all normal and reasonable charges for mandated services up to the maximum amount of services and reimbursement allowed under the Act. County is not liable for reimbursement of services which exceed the maximum per patient limits established by the Act. Physician has no obligation under this agreement to provide the services covered under this Agreement to eligible residents of County when and after such expenditure level is reached. If Physician transfers eligible residents of County to a noncontracting physician for physician services which physician is unable to provide, County is obligated to reimburse the receiving physician at the receiving physicians payment rate, but riot to exceed the maximum payment of reimbursement allowed under the Act or established by the Department. All transfers will be made to contracting physicians if possible. Per patient expenditure limits as established by the Act apply to such services delivered by the receiving physician. 4. NOTICE County shall have the duty and responsibility to give all 2 ",I~IIY;;. c'('C'/GI?!C/!)f ~.. '-27-tip notices concerning the availability of mandatory physician services from Hospital. 5. llETERMINATION OF ELIGIBILITY County shall be responsible for determining whether an applicant is eligible for financial assistance defined by the Act and shall provide eligible residents with documents and/or cards which identify persons as eligible residents. In the case of a patient who may be eligible seeking nonemergency services, Physician shall not provide such nonemergency services until County has determined eligibility of the patient, has notified Physician of the eligibility decision and has approved in writing provision of the nonemergency services. County must determine eligibility for nonemergency services within fourteen days from the date County receives a completed application. Eligibility requirements and this contract may be modified at any time by County tv reflect any statutory changes in County's indigent care obligations. Residency disputes shall be resolved by the Department. 6. NOTIFICATION OF PROVISION OF SERVICES Physician may deliver emergency services to eligible residents of County without obtaining County approval. Physician must receive written approval from County before providing nonemergency services. 7. REIMBURSEMENT PROCEDURES Physician shall present charges for physician services provided to eligible patients to County monthly. County shall reimburse Physician within thirty (30) days of presentation of the charges at the payment rate determined by the Department. All gent disputes are to be submitted for binding resolution to a panel consisting of a Hospital medical staff member who did not attend the patient, Hospital's administrator, one Hospital Board of Trustee member, County Judge, and one County Commissioner. 3 In the case of emergency physician services rendered t patient who is determined in Section 5 not to be elig for financial assistance, Physician shall be financi responsible for the services rendered to such pati~:nt. Physician reserves the right to pursue any reasonable collection effort against such patients. Physician shall have the right to bill eligible patients for non-covered charges whether the charges are for excluded services or because the charges are not payable by County due to provisions of the Act or payment policies and rates established by the Department. 8. THIRD PARTY PAYORS Physician will notify County if any eligible residents have access to any other sources of payment for the eligible services provided, but County shall be responsible for the full payment of such eligible services. Physician shall notify County of the amounts received from third party payors and reimburse County for services and amounts covered under this Agreement. 9. RECORDS Physician will provide County access to all financial records necessary to document the Physician's provision of services. Such access shall be during normal business hours of the Physician and shall be preceded by notice from County. Such notice shall be received by Physician 24 hours in advance of such examination. County shall hold all medical records in strict confidence so as not to violate the physician/patient relationship. County shall obtain a signed authorized medical consent form from the patient, authorizing the release of his/her medical records and provide the same to the Physician prior to receiving any medical~.records. 4 ~,i lll'',.~'c'c'/GI~;K/{){ .~ -'l~/-tit, 10. TERM AND RENEWAL TERMS The term of this Agreement shall be from December 12, , 198g through ~_ December 12 _ 19 g9 This Agreement may be renewed for additional one (1) year terms by written agreement of the parties at least thirty (30) days prior to the expiration of the original or any renewal term. County shall reimburse Physician according to the provisions of this Agreement for any eligible patient who continues to receive eligible physician services past the expiration of this Agreement. 11. TERMINATION AND RIGHT TO CURE Either party may terminate this Agreement upon breach of this Agreement with thirty (30) days prior written notice, provided the breaching party has been notified thirty (30) days prior to the termination notice and efforts to resolve the matter to the terminating party's satisfaction are unsuccessful. Upon termination as provided for herein, neither of the parties shall have any further duty or obligation to the other except for indebtedness due at the time of termination and indemnification of the other party. 12. FiOLD HARMLESS Each party agrees to indemnify and hold harmless the other party and its employees against and from all claims and actions brought by third parties against the other party on account of willful, intentional, negligent or illegal conduct, omissions or bad faith of the party, its agents or employees. Physician shall retain sole authority and responsibility for the services rendered to eligible patients of County. 13. ASSIGNMENT Neither party shall assign this Agreement except with the prior written consent of the other party, except as provided in section 5 hereof. 5 1~1'l1Yti . CCC/GI:K/I)L/ti-27-fi(, 14. HEADINGS Section headings are for convenience of reference only and shall not be used to construe the meaning of any provision to this Agreement. 15. COUNTERPARTS This Agreement may be executed in any number of counterparts, each of which shall be an original, and all of which shall together constitute one agreement. 16. OBLIGATIONS AS CONDITION All obligations of each party to this Agreement are conditions to further performance of the other party's continued performance of its obligations under the Agreement. 17. EXCLUSIVE RIGHTS Only the parties to this Agreement have the exclusive right to bring suit to enforce this Agreement and no other parties may bring suits as a third party beneficiary, or otherwise, to enforce the Agreement. 18. SEVERANCE Should any part of this Agreement be invalid or unenforceable, such invalidity or unenforceability shall not affect the validity and enforceability of the remaining portions. 19. LAW This Agreement shall be construed in accordance with the laws of the State of Texas. 20. AMENDMENT This Agreement may not be modified except in writing executed by both parties to this Agreement. 21. NOTICE Any notices, demands or communications required, permitted or desired to be given hereunder shall be deemed effectively given when personally delivered or mailed by prepaid certified mail, return receipt requested, addressed as follows: 6 Kerr bounty Ju~~ge Kerr County Courthouse t