ORDER NO. 1f3440 MOTION TO APPROVE MANDATED PROVIDER AGREEMF;NT BETWEEN DR. D. .J. TRiJITT, D.O. AND KFRR CC~IJNTY On this the 9th day of_ Fenruary 1.99, upon motion made Icy Commissioner flay, ser_onded by Con~znissioner Baldwin, the [~ouri: unanimously al~prc3ved County ~7udge Edwards tc~ sign a Mandated Provider Ac~reernent on behalf of Kerr County, het:wean Dr. D. J. Truitt, D.O. and Kerr County. COMMISSIONERS' COURT AGENDA REQUEST /. ~ PLEASE FURNISH ONE ORIGINAL AND "ETGITT" COPIES OF THIS REQUEST AND DOCUMENTS TO BE REVIEW CD BY THE COURT. MADE BY: JUDGE EDWARDS OFFICE: MELTING DATE: February 9, 1989 TII`1E PREFERRED: SU[3JE CI': (PLEAS F. [3[: SPECIFIC: APPROVE MANDATED PROVIDER AGREEMENT TO DR. D. J. TRUITT, D.O. 1•;S'I'IMA'i'[;D I.ENG'I'H OI~ PRf:SI?N'I'A'I'ION: II~ PERSONNI~:1. MA'T"I'F?I2: NAME? O1~ E?MPLOYI~.E•;: NAM f; OI' PI•;RSON ADDRESS 1 NG 'I'H l? COUR'T': '['IME; I~OR SUE3MI'T"I'1NG THIS KF.QUT•;ST FOR COUR'T' 'TO ASSURE THA'I' T1II MA'I"I'ER IS POSTED IN ACCORDANCE W1'I'H ARTICLE 6252-17 [S A5 FOLi.OWS: ME1~I'INGS HELD ON SECOND MONDAY: 12:00 P.M. PRL'VIOUS WEDNESDAY MEE'T'INGS IIEI.D ON THt1RSDAYS: 5:00 P. M. PREIJIOUS TFIURSDAY. I F PREFERABLE, AC;I?NDA REQUESTS MAY BE MADE ON OI~ i~ ICE STATIONERY WITEI THE ABOVE INFORMATION AT'T'ACHED. THIS REQUEST RECEIVED BY: 'I'IIIS REQUEST RECEIVED ON: a A.M. P. M. ALL AGENDA REQUESTS WILL BE SCREENED BY THE COUNTY Jt1DGE'S OFFICE TO DE- TERMINE IF ADEQUATE INFORMATION HAS BEEN PREPARL'D FOR THE COUR'1"S FORMAL CONSIDERATION AND ACTION AT TIME OF COURT MEETINGS. YOUR COOPERATION WILL BE APPRECIATED AND CONTRIBUTE 'T'OWARDS YOUR REQUEST BEING ADDRESSED A7' THE EARLIEST OPPORTUNITY. AGREEMENT (PHYSICIAN -GENERAL) of This Mandated Provider Agreement is entered into on the 1988, by and between D _J_ TRUITTL D.0 ------------------------------------------' (hereinafter called "Physician", whether one or more), and KERR COUNTY, TEXAS, acting by and through its duly authori~:~ed 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 day l t_-,c Stealth Care Financing Administration. Unless otherwise agreed upon, Physician shall deliver, or arrange to be ~.elivered, Physician services that are considered mandatory 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 t~ublic physician or phys^ian district has a legal obligation to serve. County =hall 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 not 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 ~n~rices concern_~.g the availability of mandatory physician services from Hospital. 5. DETERMINATION OF ELIGI[3ILITY 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 i~~entify 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 to 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 obtriining 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 to , patient who is determined in Section 5 not to be eligibl~ for financial assistance, Physician shall be financiall responsible for the services rendered to such patient Physician reserves the right to pursue any reasonablE collection effort against such patients. Physician shall have the right to bill eligible patients foi non-covered charges whether the charges are for exclude 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 10. 'T'ERM AND RENEWAL TERMS ThG term of this Agreement shall be from , 193 through ~___ ________, 19 This Agreement ;nay be renewed for additional one (1) year terms by writte agreement of the parties at least thirty (30) days prior t 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 RIGEiT 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. BOLD HARMLESS F.ach 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'I lY~ . CCC/G1.1