HomeMy WebLinkAbout20123367.tiff Irr nr CORRECTIONAL
,/` in., HEALTHCARE COMPAMMES
www.correctioncare.com
6200 S.Syracuse Way#440. Greenwood Village, CO 80111 .V
SENT VIA EMAIL AND FED EX
November 21, 2012
Nancy Kroll, Director of Inmate Services
Weld County North Jail Complex
2110 O Street
Greeley, CO 80631
Re: Contract termination and handling Offsite Medical Services and HIV, Hepatitis and Biological
medication claims and caps
Dear Ms. Kroll,
In order to bring a timely and orderly resolution to the administration of offsite claims after the termination of the
Agreement for Inmate Health Care Services between CHC and Weld County at midnight on November 30, 2012,
the following represents the plan of action for handling the disposition of offsite medical expenses, the cost of HIV,
Hepatitis and Biological medications and final reconciliations pursuant to our contract:
Pro-Rated Cap Calculations
• Section 1.15.2 of the contract sets CRC's maximum liability for costs associated with the provision of
prescribed medication related to treatment of Acquired Immune Deficiency Syndrome ("AIDS"), Human
Immuno-deficiency Virus ("HIV"), Hepatitis C, organ transplants and neuromuscular disease, and
Biological medications at $5,000 in the aggregate per Contract Year to be pro-rated for any partial Contract
Years. Therefore, the aggregate capitation for 2012 will be pro-rated for eleven months beginning January
1, 2012 to November 30, 2012 and equal $4,583.33 ("Pro-Rated Medication Cap").
• Section 1.19 of the contract sets CHC's maximum liability for costs associated with the provision of off-site
medical services or other healthcare services at $100,000 in the aggregate per Contract Year to be pro-rated
for any partial Contract Years. Therefore, the aggregate capitation for 2012 will be pro-rated for eleven
months beginning January 1, 2012 to November 30, 2012 and equal $91,666.67 ("Pro-Rated Offsite Cap").
Claim Handling/Final Invoicing Process
• CHC will provide a 31 day run out period from December 1, 2012 to December 31, 2012 to allow for
verification and processing of claims for services provided through November 30, 2012 and received by
CHC by December 31, 2012.
• All claims for offsite services provided prior to November 30, 2012 that are received by CHC after
December 31, 2012 will be forwarded to Weld County for handling and payment.
• If CHC does not have sufficient information to properly adjudicate and pay a claim as a result of Weld
County not allowing access to necessary inmate information, these claims will be denied, provided to, and
will be the responsibility of Weld County to process and pay.
• CHC will run a final Cap Year-to-Date Report Summary and will provide this report to you on or before
February 4, 2013. If the offsite expenses paid by CHC are less than the Pro-Rated Offsite Cap (after
applying any amounts over the Pro-Rated Medication Cap) the report will be accompanied by final rebate
check for the difference between the amounts paid by CHC and the Pro-Rated Offsite Cap. Should the
Providing comprehensive medical, mental and behavioral 2012-3367
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offsite expenses paid by CHC (after applying any amounts over the Pro-Rated Medication Cap) exceed the
Pro-Rated Offsite Cap, the report will be accompanied by a final invoice to be paid by Weld County within
30 days. The report will also include any credit or charge related to the MADP and staffing reconciliation
calculations contained in paragraphs 8.1.1 and 8.1.3 of the contract.
If you have any questions or concerns related to this action plan please contact me immediately.
Sincerely,
. �
Shelton Frey, JD CCHP
Vice President and General Counsel
Correctional Healthcare Companies, Inc.
P.O. Box 5078
Greenwood Village, CO 80155-5078
(720) 622-8041 Direct Line
(720) 458-3426 Fax
shelton.frey@correctioncare.com
c: Sean P. Conway, Chair, Board of County Commissioners
John Cooke, Sheriff
Providing comprehensive medical, mental and behavioral
healthcare solutions to the criminal justice system nationwide.
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