Item 1.~ Consideration of Peterson Regional Physical
Hospital Dr•ganization Agreement with Ker^r Co+_+nty "F'HO" and
authority for the County Judge to sign same. (Treasurer^)
ORDER N0. ":,030
RF'F'ROVRL OF PETERSON REGIONRL F'HYSICIRN HOSF'ITRL
ORGANIZATION AGREEMENT WITH KERR COUNTY "GHO"
AND RUTHORIZATION OF THE COUNTY JUDGE TO SIGN SRME
On this the 9th day of November- 1995, upon motion made by
Commissioner Holekamp, seconded by Commissioner Oehler^, the
Court unani^ously approved by a vote of 4-0-0, to authorize
the County Judge to sign the F'eter•son Regional Ghysician
'~ Hospital Or^ganization Agreement with Ker^r^ County "F'HO" as
presented to the Court and authorize retirees rate to 6e set
at ffi105.0+Z+ per month.
PETERSON REGIONRL PHYSICIRN HOSPITAL ORGANIZATION
RGREEMEN7 WITH KERR CDUNTY
1.0 PRRTIES TO THE AGREEMENT
This agr^eement is made and entered into effective as of the
1st day of Dece~6er, 1995 by and between Peterson Regional
Physician Hospital Organization, a Texas non-profit
corporation ("F'RF'HD") and Kerr County, ("COUNTY").
2.0 RECITALS
WHERERS, F'RF'HO is engaged in the business of contr•acting for•
the provision of medical and health car^e services and is
prepared to provide such services to County employees pursuant
to the terms and conditions of this Agreement;
WHERERS, COUNTY has established a self-funded employee health
and welfar^e benefit plan for- certain of its employees and
their dependents and has entered into a Rdministr•ation
Agreement with EBF', a Third F'ar•ty Administrator-, to provide
administration ser'vices for^ the plan. The Rdministr•ation
Rgr•eement is made a part her-eof by reference hereto as
Rttachment C.
WHERERS, COUNTY has and/or• desir^es to enter into contractual
ar•r•angements with physicians, health car^e professionals,
hospitals, third par^ty administrators, cons+.+ltants and other
parties to arrange for^ and facilitate services for^ the
Co+.+ntyr s health and welfar^e benefit plan;
THEREFORE, in consider^ation of the premises and the mutual
promises herein stated, the parties agr-ee as follows:
3.0 DEFINITIONS
3. i Bills mean the bills of the F'ar•ticipating P'rovider' on
forms UP-92 or^ HCFR 1500, as applicable (or their- successor'
forms), for- the Cover^ed Services provided by s+_~ch
Participating P'rovider's.
3.2 This section has been omitted.
3.3 Cooayment means a payment which may be collected directly
"' by a Participating Provider fr^om a Flan Member- in accordance
with the terms of the F'ayor's Plan.
F'AGE 233
3.4 Covered Services means those medical and hospital
services which Flan Member^s ar•e entitled to pursuant to the
... Plan provided by or administered by the Gayor. For^ purposes
of this definition, "medical and hospital services" shall
include only those ser^vices, facilities and equipment
customarily provided by Physicians and Hospital as of the
Effective Date and which Physician and Hospital deem
appropr^iate to pr^ovide during the ter^m of this Agreement.
3.v Hospital means Sid F'eter^son Memorial Hospital which is a
Participating F'r•ovider^ and any other- facility that has
contracted with the F'RF'HO to pr^ovide certain hospital services
to Flan Members.
3.E Mon-covered Services means ser^vices for- which F'ayor• is
not required to provide to Members p~_~r^suant to the Flan
including but not limited to ser^vices which ar•e not author^ized
by Payor as part of the utilisation control progr^am.
3.7 F'ar•ticipatino F'r•ovider^ (s> means a primar^y care
physician, specialist physician, hospital or• other' health car^e
provider who has contr'acted with F'RF'HO to pr^ovide or arrange
for- the provision of health car^e ser^vices to Plan member-s. A
directory of Participating F'r•ovider•s including the Ancillar^y
Service F'r^ovider•s are listed in Attachment D.
3.8 Favor, means the specific employer-, insurance carr^ier^,
,_„ and/or other entity that sponsor's and/or• administers (as
applicable) health plans, on behalf of one or more of such
plans (collectively, a Flan) to enable its Flan Member^s to
have access to health care provider^s. Kerr- Coi_inty is the
Gayor in this agreement
3.9 F'hysician means a pr^imary car^e physician or^ specialist
physician who is a F'ar^ticipating F'r•ovider- and who has
contr'acted with GRF'HO to provide cer^tain medical services to
Members.
3.10 Flan means a written pr^ogr^am adopted by the County which
specifies the health care ser^vices which F'ayor shall provide
as a benefit to Members and the teems and conditions
applicable to the pr^ovision of such services.
3.11 Flan Member means any individual eligible to receive
benefits under a Flan. The phrase "its Flan member^s", or^ a
phrase of similar impor^t as ~_~sed with r^espect to County,
refers to the Flan Members of Flans for' the County.
3.12 Third F'arty Administrator^s (TPA) means the individual or
company that contracts with employees who want to self-insure
the health of their employees. This company usually handles
claims processing and other administrative fi_inctions
associated with the managed care contract. The TF'A for this
agreement is E8F' HealthPlans, Inc.
4.0 TERM, TERMINATION RND RIGHTS UPON TERMINATION OF THIS
AGREEMENT
F'AGE 234
4.1 Term. The teem of this agreement shall begin as of
'^ Decewber i, 1995 and end on midnight of Navewber 30, 1996
subject, however, to earlier termination by County or• F'RF'HO as
her•eafter• provided. The teem of this Rgreement shall
automatica]ly renew for• an additional one (1) year teem,
unless terminated as provided herein.
4.2 Termination This Agreement may be terminated for cause at
any time d~.iring the Rgreement teem upon (30> days' prior
written notice by either- party, unless it is mutually agreed
to 6y the parties that the grounds for• termination with cause
have been remedied during the notice period. This agreement
may be terminated by either- party with or• without ca~.ise
effective at the conclusion of the then current term upon
written notice to the other- party at least ninety (9Zr) days
pr•ior• to the concl~_~sion of such teem.
4.3 This Aor•eement may be terminated without cause at any
time during the Rgreement upon ninety (9Q~) days prior- written
notice by either- party.
4.4 Ri~r_hts Upon Termination. Upon termination of this
Rgreement, pursuant to Section 4. 2, F'ar•ticipating Providers
shall continue to provide Covered Services to Plan Members
then inpatients of the Hospital and entitled to services
p~.rr•s~_iant to the Flan until s~_ich Flan Piembers ar•e discharged
~- transferred consistent with sound medical practice. F'ayor•
shall pay F'ar•ticipating F'r•ovider•s in accordance with
Rttachments A and E to this Rgreement for• services r•ender•ed
F'ar•ticipating F'r•oviders to such Members. Payment shall
continue to be made within the time Frame established in v.l
Method of Payment. F'ayor• and Participating F'r•ovider•s shall
continue to fulfill their obligations under^ this Rgreement
with respect to: (i) payments due F'ar•ticipating Pr•ovider•s,
(ii) records maintenance requirements and (iii> insurance
r•eq~_iirements. if F'ar•ticipating Provider^s arse req~_rested to
provide Covered Services to Flan Members after- the effective
date of termination of this Rgreement, F'ayor• will pay
Participating F'r•ovider•s according to F'ar•ticipating F'r•ovider•s
billed charges
5.0 OBLIGATIONS OF THE PARTIES
o r•
by
v.1 The F'RF'HO has the authority to bind its F'ar•ticipating
F'rovider•s, listed in ATTACHMENT D, to the Agreement with the
Co~.rnty and is acting on behalf of its Participating F'r•oviders
in entering into this Agreement. F'RF'HO r•epr^esents and
warrants that it has entered into individ~_ral agreements with
each Participating Provider listed in Rttachment U.
S.~ F'lan Member- Incentives. County will use its best efforts
to incor•por•ate financial incentives into the Flan for Flan
^ Member utilization of the services of F'RF'HO. These financial
incentives shall take the form of, but are not limited to,
reduced copayments, red~_rced deductibles, and reduced
out-of-pocitet limits.
F'RGE 23~
5.3 Services and Rates._ PRPHO agrees to contract with
"" participating F'r-oviders far the per•for-mance of Covered
Services, which have been authorized by Payor- and ordered by a
Physician, at the rates contained in the Physician
Compensation Schedule annexed her•etn as Attachment E, and made
a part hereof. Such Covered Services may be provided by
F'<'ar•ticipating Pr•ovider-s or• any appr•opr•iately licensed
affiliate of F'RF'HO.
v.4 Eligibilit~for• Service.
(a> F'RF'HO represents and war•r•ants that its Participating
Provider cnntr-acts will state that the Par^ticipating
Provider will be responsible for- verifying the
eligibility status of a Peneficiary with the F'ayor• or• its
representative. The F'ayor• or• its representative agrees
to maintain cur•r•ent lists o1' covered Flan Members.
(b) If Flan Member is unable to provide sufficient
information for Rrovider• to verify appr•opr•iate coverage,
Provider may r•equir•e Flan Member- to personally guarantee
payment for- Covered Services r-ender•ed to Flan Member-.
S.5 Emergencv Services Emergency Services shall be pr^ovided
without prior verification of eligibility or• authorization in
case of medical emergencies where delay in treatment would
,~ result in treat to life or• impair-ment of bodily f~.inctions as
reasonably deter-mined by the Participating Hospital Emergency
Department's Staff.
In the event a Flan Member- enters a F'RF'HO Hospital through the
Emergency Room, b~_it subsequently is admitted as an inpatient,
then the Emer^gency Room rate in Attachment A is to be paid to
Hospital, in addition to the applicable inpatient per- diem (or
X off of charges) rate. Further, if the patient enters
Hospital thr^ough the Emergency Room, but subsequently
undergoes outpatient surgery, or• receives other outpatient
services, the Hospital and/or Participating F'rovider•s shall be
reimbursed for- both the Emergency Room visit, and the
applicable rate agreed ~_~pon for the additional outpatient
services.
v.6 Observation Services. In the event an observation
patient is subsequently admitted as an in patient to Hospital,
the agreed ~_~pon observation r•eimbur•sement rate will be paid to
Hospital and/or F'ar•ticipating Providers in addition to the
applicable inpatient per- diem (or- '/. off of charges) r-ate.
Further, if an observation patient subsequently undergoes
o~_itpatient sur•ger•y, or• receives other- "non-obser•vat ion"
outpatient services, then the observation rate shall be paid
to Hospital, in addition to the applicable outpatient rate
agreed to herein. Observation rates can not be replaced with
~-- per- diem r•ate:>.
v.7 Laboratory and Radiology Operational Protocols. R~_~les
and Regulations and Bylaws of the Hospital Medical Staff shall
be followed for- all inpatient and surgical outpatient
F'RGE X36
procedures far labor-ator-y ad r•adioingy protocol and for
reimbursement purposes.
5.6 Transfer^s. In the event a patient at Hospital is
transferred to a non-PRF'HO health care facility, the receiving
facility shall be responsible far• making r•eimbur•sement
arrangements with County. In the case of a transfer from
Hospital, Hospital shall r^eceive no reimbur^sement for those
hospital expenses incur-'-ed in a non-F'RF'HO facility. Hospital
shall be r•eimb~ar•sed in accordance with Attachment A only for
the days in which the patient was in a F'RF'HO facility. In
addition, when a patient is tr^ansferred from Hospital, F'RF'HO
shall not pay for any transpor^tation costs or• any health care
services f~_v-nished by a non--F'RPHO health care facility.
5.9 This section was pi_irposely omitted from the Agreement.
5. 1~ Billing of Flan-Members F'ar•ticipating providers shall
look only to F'ayor for payment of Covered Services r^endered
to Flan Members in accordance with the terms and conditions of
this Rgr•eement. Notwithstanding this limitation, Flan Members
are primarily responsible and may be billed directly by
F'ar•ticipating F'r•oviders for' Copayments, deductibles and
Non-Covered Services.
pRF'HO physician can negotiate with the patient regarding the
patient's payment for^ services in the event that the F'RGHO
,,_., physician and the F'ayor or• its r^epr^esentative have a
disagreement over^ the medical necessity of proposed services,
provided that the F'RF'HO physician has informed the patient
abo~_i1: this dispute and the fact that the patient will be
personally responsible for• payment.
Nothing within the provisions of this agr^eement prohibits the
F'RF'HO provider^s fr^om pursuing the patient for collections of
fees for ser-vices determined to be medically necessary in the
event the F'ayor• or its representative fails to pay the claim
for• such services in accordance with section 5.11 Method of
Payment, or^ in the event of any bankruptcy, r•eceiver~ship or
insolvency of the Co~_inty.
5.11 Method of F'ayment. The contract between the F'RF'HO and
F'ar^ticipating F't•oviders shall provide that F'ar^ticipating
F'r•ovider^s shall bill F'ayor• at standard r°ates and payment will
be based upon the rates agr^eed to in Rttachments A and E for
all Covered Services. payments made by F'ayor• for the
provision of medical services to a Flan Member must be
received by F'r•ovider•s within thirty (~0) days of F'ayor's
receipt of an accurate, legible, and complete claim. In the
event that payment for^ medical services is not r^eceived by
Providers within 30 days of F'ayar's receipt, the F'ayor- shall
reimburse F'r•nvider•s with the total charges for the claim,
excluding any discounts. Review of claims by F'ayor•, or any
or° any other delay on the part of F'ayor•, or• any other
designated representatives, shall not offset the above
r•eq~airement to pay claims within 3¢~ days of F'ayor•~ s receipt.
P'rovide'- agr^ees to waive the 30 day payment deadline for
F'AGE ~.~7
claims which ar•e subject to coar•dinatiorr of benefits, claims
which need investigation due to medical necessity, and claims
"' incurred by Plan Members wfrose effective date on any Flan is
less than one year. These claims must be paid in 9S+ days of
receipt of the claim in order to receive the negotiated
disco+_~nt.
The hospital will bill the County for the full, undiscounted
amount for• the hospital services provided for- which the mem6er•
is liable. The County will apply the discount and note it on
the explanation of benefits. All clean bills will be paid by
the County within 3~ days, or• the discount will be waived.
The County agr^ees to process Hospital bills for covered
services rendered to eligible covered Plan Members and if
appr'opr'iate remit the F'lan' s co--ins+_ir•ance amount in accordance
with Hospital's standard rate schedule, less the discount
agreed to in Attachment A. Hospital agr^ees to allow audits of
their billings at times mutually agreed upon between Hospital
and the County.
5.12 Rates. Participating Provider rates as listed or•
described in Attachments A R E may be renegotiated upon ninety
(90) days' prior- written notice of request by F'RF'HO to County.
5. 13 Access to Recar•ds The contract between the F'RF'HO and
Participating Providers shall provide that medical records
,,,,, shall be, and remain the pr-oper•ty of P'ar'ticipating Providers
and shall not be accessed, removed or- tr-ansfer^red from
Participating F'r•ovider•s except in accordance with applicable
state and federal law and regulations and Hospital rules and
r•eg~_+lations. To the extent permitted by law Hospital
r•~.iles and r°egulations, Hospital shall permit the F'ayor to
inspect and make copies of said medical r'ecor'ds providing
that F'ayor• has obtained prior written consent from Member
a+athor•izing Hospital to release such information to F'ayor•.
For• purposes of this Section, medical recor^ds shall include
hose records that are, or• will become part of the medical
record of the patient. Payor• shall reimb~ar•se Participating
F'r^ovider^s at the rate of 8.25 per page for• copying r•elated
to the provision of Participating Provider's medical records.
5.14 Confidential Information. Tire contract between PRF'H~
and P'ar'ticipating F'r•ovider•s shall provide that d+.ir•ing the term
of this Agreement and thereafter, Payor• and P'ar'ticipating
Providers shall ensure that Payor• and Gar•ticipating P'r'oviders,
and their dir'ector's, officer's, employees, contr'actor's and
agents hold Confidential Infor-mat ion in the strictest
confidence and in accordance with state and federal law.
"Gorrfidential Information" shall include without limitation
all information and r'ecor'ds whether oral or written or
disclosed pr'ior' to or s+_ibseq+aent to the execution of this
Rgreement r'egar'ding the following: patients, ~_itilization
~^ review, q~_+ality assurance, finances, vol+.ime of b+.+siness,
contracts and prices. Payor r^epr•esentative shall r'etur'n or
destroy all confidential information received from the
Participating L='rovider•s within thirty (.~) days following
termination of this Rgreement for any reason. l'he parties
PACE 238
agree that discloser°e of a party's Confidential Information
other than in accordance with this section shall cause
'~ ir•r•eparable inj~.iry to s~_rch party, and that the in.jur^ed party
may seek injunctive relief to prevent the other party's breach
of this Section.
5. 15 Solvency of Flan. F'aypr• shall secure and maintain
appropriate r•egistr•ation/certification as may become necessar^y
to operate as a direct provider/employer health care plan
under the laws of the State of Texas. In the event that state
r•egulator•y agencies r•equir•e F`ayor• to file an Rnn~.~al Report,
Employer shall provide F'RF'HO with a copy of the report, and
shall provide F'RF'HO with copies of each new Rnnual Repar^t
prior to the date of each renewal of the teems of this
Rgr^eement. Employer^ agr^ees to notify F'RF'HD immediately in the
event registration/certification is denied or• becomes
restricted in any way or terminated.
5.1E Stop-loss Insurance. F'ayor• agr^ees that any stop-loss
insurance agreements which protects the Employer's risk for
F'ar-ticipating pr•ovider• care costs shall be with a solvent
company that is authorized to do business in Texas. F'ayor^
shall give F'RF'HO not less than thirty (30> days' pr•ior• written
notice of any cancellation, non-renewal or• mater^ial
alteration of such stop-loss insurance coverage. The F'ayor
shall provide a copy of si_rch policy to the F'RF'HO annually
and/or whenever changes ar•e made to cover^age.
5.17 Rdver^tisements. Neither party shall use any
advertisement that includes the other's name or• that describes
or• refers to the other's products, unless such advertisement
has been approved in writing by the other party in advance of
its ~_rse or• distribution. F'RF'HO agrees to allow the
publication of its participating provider's names, addresses,
and phone numbers in Rttachment D in ttre County's Directory of
Healthcare F'r•ovider•s for• the F'ayors in Rttachment C. The
County ayr^ees to identify the F'RFHO as a cpntr•acted entity.
5.18 F'r-ofessional Relationships. Each party agrees that no
provision of this Rgr•eement shall have the effect of
infringing ~.~pon Participating providers' professional
relationships with Flan Members.
6.0 ACCESS
Each par^ty agrees with the other as follows:
6.1 F'RFHO agrees to allow County's Flan Members access to the
F`articipating Providers listed in RTTRCHMENT D, County shall
notify F'RF'HO when its Flan members are to begin such access.
6.2 F'RF'HO shall calculate the rates herein agreed to against
thre actual charges (her^einafter•, r^eferr•ed to as "reprice" or
~" "repricing") in the Bills attri6~atable to eligible Flan
Members.
6.3 Co~.rnty shall refer to F'RF'HO in a timely manner^ any
complaint, contr•over•sy or• contr^act problem arising out of
F'RGE X39
delivery of ser^v ices or- benefits by the Participating
Providers. F'RF'HO shall use reasonable effor^ts to resolve in a
timely manner any controversy referred to by County.
6.4 The parties acknowledge that patients' medical r-ecor-ds
are confidential and shall not be disclosed to third parties
without the consent of the patients, unless otherwise
permitted or required under- applicable law.
7.0 CONFIDENTIAL INFORMRTIONq INTELLECTUAL PROPERTY
7.1 The parties reser-ve the ownership af, and the r^ight to
the control and use of, their names and all copyrights,
symbols, tr-ademarks, service mar^k s, or other intellectual
property rights, pr^esently existing or• later- established.
Neither party shall ~_~se the name or any such intellectual
pr-aper•ty rights of the other- party in advertising or^
promotional materials or otherwise without the pr-ior written
consent of s~_~ch other- par^t y. Any per-m itt-ecf use by a par-ty of
the name or any such intellect~.~al property eights of the other
party shall cease immediately upon the termination of this
Agreement, ~_inless other°wise agreed to by the other party.
Notwithstanding the foregoing, each party hereby grants the
other party the right to use its name, address, and telephone
n~_imber in connection with the perfor^mance by the other party
of its obligations here~.mder-.
,,,, 7.2 C~uarterly Report: Co~_inty agr-ees to provide quar-ter•ly
reports to F'RF'HO which identify specific utilization data by
hospital service and by Participating Provider, including but
not limited to, the num6er• of Members, admissions and patient
days at Hospital.
8.0 GENERAL PROVISIONS
8.1 Provisions Separable. The provisions of this Agreement
are independent of and separable from each other, and no
pr^ovision, shall be affected or• r-ender-ed invalid or•
unenforceable by virtue of the fact that for any r-eason any
other- or- others of them may be invalid or unenforceable in
whole or in par^t.
8.'. Diso~xtes. In the event that GRGHO and County are unable
to resolve any matter in dispute between them to the mutual
satisfaction of both parties, pRF'HO and County may agree to
have dispute mediated by a mediator or an ar-bitrator mutually
acceptable to the F'RF'HO and the C:o~anty from the National
Health Lawyers Association Disp~_ite Resolution Service. If
mediation fails to resolve the dispute any such dispute would
be s~_ibmitted to binding arbitration. Each party shall pay its
own expanses in connection with any mediation proceeding.
In the event any .j~_tdicial proceeding is necessary to enforce
or interpret the terms of this Ryreement, the prevailing party
~"' shall be entitled to reasonable attor^ney's fees, costs and
expenses, in addition to any other- r-elief to which such party
is entitled.
F'AGE 240
8.3 Waiver of Br-each. The failure of County or^ F'RF'NO to
"`~ object to or to take affirmative action with respect to any
conduct of the other which is a breach of this Rgr-eement shall
not be construed as a waiver of that breach or of any prior or•
fut~_ire br^eaches of this Rgr•eement.
8.4 Entire Rgr•eement. This Agreement, together with
Rttachments A, C, 17, and E, which are attached hereto and made
a part hereof, constit~_tte the entire ~ander•standing of the
parties to this Agreement, and supersede al pr^ior proposals,
r-epr•esentations, communications, negotiations, and agreements
between the parties whether oral or• written.
8.5 Choice of Law. This Agreement shall be inter•pr•eted in
accordance with and governed by the laws of the State of
Texas.
8.6 Assignment This Rgr•eement or any of its pr^ovisions
shall not be assigned, delegated or• transferred by either
party witho~_tt the pr•ior• wr^itten consent of the other party.
8.7 Rinding Effect. This Rgreement shall be binding upon,
and shall inure to the benefit of, the parties hereto and
their- s~_tccessor:> and permitted assignees.
8.8 Independent Contractors and Rights of Member^s. F'RPHO and
-- Co~_~nty ar^e independent contractors, and this Agreement shall
not constit~_ite the formation of a par•tner•ship, .joint ventur^e,
employment or master-/servant relationship. The par-ties shall
not exec^cise control over the performance of the other
hereunder.
8.4 Rmendment. This Agr^eement may not be amended ar- changed
in any of its provisions except by a subsequent wr^itten
agreements, signed by duly authorized r•epr•esentatives of
County and F'RF'HO.
8. i0 State Rppr•ova1. If the laws of the state in which this
Agreement is to be performed require appr-oval of this
Agreement by any t•egulatory agency of such state, then this
Agreement shall only become effective upon the giving of s~.tch
appt•oval by the state agency.
8. ii Exclusivity. By entering into this Agreement, the F'RF'HO
and the County are not and will not be limiting their ability
to enter other disco~_tnt arrangements with other parties.
In an effor^t to build a mutually respectful business
partnership, at all times, r-epr^esentatives of the F'RPHO and
the County agree to support the other- par^ty and to promote the
positive aspects of the other- party to the business community.
8.1~ Insurance and Indemnification. Hospital and F'RF'HO, at
their sole cost and expense, shall maintain si_ich policies of
general liability, professional liability, or• self-insi_ir^ance
as shall be necessar^y to insure them and their employees
against any claim or• claims for- damages arising by reason of
F'AGE X41
personal in,ji_rr•ies or• death occasioned, directly or' indirectly,
in connection with the performance of any medical service
"' provided her•eunder•, the use of any property, facilities or
eq~_ripment provided by Hospital or• F'RF'HO and activities
performed 6y Hospital or F'RF'HO in connection with this
Rgreement. Memorandum copies of the above insurance policies
shall be provided to the Co~_rnty ~_rpon the County's request.
The County, at its sole cost and expense, shall pr^ocure and
maintain such policies of general liability and other
insurance as shall be necessary to insure the County and its
employees against any claims or- claims for- damages arising by
reason of personal in,jur^ies or death occasioned, directly or•
indirectly, in connection with the performance of any service
by the County, the use of any property, facilities or
equipment provided by the County and the activities per-for^med
by the Co~_rnty in connection with this Rgreement. Memorandum
copies of the above ins~_rrance policies shall 6e provided to
F'RF'HO upon F'RF'HO' s request.
Each party shall be responsible for• its awn acts or omissions
under this agreement.
8.13 Notice. Rny notices or other communications required or
contemplated under the provisions of this Rgreement shall be
in writing and delivered in person, evidenced by a signed
receipt, or' mailed by certified mail, return receipt
,_ requested, postage pr-e paid, to the addresses indicated below
or to such other persons or addresses as County or F'RF'HO may
provide by notice to the other. 'The date of the notice shall
be the date of delivery of the notice to the other. The date
of the notice shall be the date of delivery if the notice is
personally delivered or the second day following the date of
mailing if the notice is mailed by certified mail.
RDDRESS DF PARTIES:
PRPHO: COUNTY:
Peterson Regional F'HO Kerr County Employee Health Care Flan
710 Water St. 700 Main St.
Kerrville, Tx 78028 Kerrville, Tx 78029
8.14 Unforeseen Circumstances. In the event that Hospital
does not have pr^o per facilities to treat Flan Members or• in
the event of circumstances beyond its r•easona6le control such
as major- disaster-, epidemic, war, complete or• partial
destruction of facilities, disability of a significant number
of personnel or- significant labor disputes, Hospital shall
provide health services to Flan Members to the extent possible
according to its best .judgement or• limitations of such
facilities and personnel as are then available, but
Hospital shall have no liability or• obligation for delay or
'"' fail~_rre to provide or arrange for such services due to lack of
available facilities or personnel in such disaster, epidemic,
etc., or labor dispute, or other cause beyond the control of
Hospital.
F'AGE 242
IN WITNESS WHEREOF, the par^ties have executed this Rgr•eement,
effective the date first set forth above.
Organizations:
Peter^son Regional F'HO
By:/s/ Robert H. Walther
Title: F'r^esident
Date: 11/c9/95
Kerr County
/s/ Robert R. Denson
County Judge
il/~9/95
ATTACHMENTS
RTTRCHMEN'T R HOSF'ITRL RRTES
ATTACHMENT B Omitted
ATTACHMENT C Rdministr•ation Rgr•eement
ATTACHMENT D F'HYSICIRN PROVIDER DIRECTORY
RTTACHMENI' E F'HYSICIRN RRTES
ATTACHMENT A
Hospital Rates
Sid F'eter•son Memorial Hospital Charges are:
Billed Inpatient Charges less five percent Sr(
Pilled Outpatient Charges less five percent 5~(
RTTACHMENT C
Administration Rgr•eement
TF'R
Effective Date
EBF' HealthF'lans, Inc.
3109 West 41st Street, Suite 103
Sioux Falls, SD 5715"/CB~
ATTACHMENT E
Physician Rates
Physician rates for the F'RF'HO, excluding Rnesthesia, will be
meas~_ired against the 80th percentile of Medical Data Research
(MDR) database for all Radiology codes (70000 series), 75th
percentile of MDR for• F_valuation and Management Procedures
(99000 series) and the 70th percentile for^ all others and
reduced as needed. For• Rnesthesia the claims will be paid at
90~ of the submitted fees, reflecting a 10:( discount from
Rnesthesiars standard rates. Physicians providing services
through our ancillary service pr•ovider•s will deliver services
at rates shown in Rttachment F, if applicable.
This attachment will also become a permanent attachment to the
Par•ticipal;ing Pr•ovider^ Agreement - Rppendix R, Agreement 01
F'AGE '43
Item 1.i Consider and discuss ar-chitectur•al plans for the
remodel of the Courthouse. (County Judge)
The Rrchitect stated the work would have to be done in three
phases. There are no decisions on what will be done first and
the brae prints that are done now are pr-eliminar-y plans. The
heating and air conditioning has been inspected and we intend
to ease the same system to cut down on the cost and we feel the
basement can be used for storage.
COMMISSIONERS' COURT RDJOURNED RT 12:00 P. M.
The foregoing minutes fr^om Voli_rme U, page 197 thru 244 were
found to be correct and ar^e hereby appr^oved this the 11th day
of December^ i99~.
(SERE)
/1 t
pRTRICIR DYE, COUNTY ERK
i~ -
' +_-----
R EH RN,
C~[~SSIONER F'REC # 1
~f e .,
~_ H~LRCN Y, ,
COMMISSIONER F'REC #.L`
R. t7EYV80N, COUNyY JUDGE
FrLE1gN K. HOLEKRMF',
COMMISSIONER F'REC # 3
E
RR CE OEHLER,~
COMMISSIONER F~REC # 4
F'RGE 244