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HomeMy WebLinkAboutDR FREDERICK SCHERR MD - CONTRACT - AGREEMENT MISC - DR FREDERICK SCHERR MDPROFESSIONAL SERVICES AGREEMENT This Professional Services Agreement is between The City of Fort Collins and Dr. Fredrick Scherr MD for the purpose of acting as Medical Director for the Occupational Health Clinic serving The City of Fort Collins employee’s for work related injuries, and is effective February 18, 2016. RECITALS The City of Fort Collins is a municipal corporation and is self- insured. The City of Fort Collins desires to engage Physician to provide Medical Director Services. The parties therefore agree as follows: 1. Duties and Obligations of Physician. a. Coverage Services. (i) Physician will provide the Coverage Services as more fully set forth in Attachment A in accordance with the service standards set forth there, which is incorporated into this Agreement. b. Licensure; Certifications; Medical Staff Privileges. During the Term of this Agreement Physician will: (i) Maintain in good standing his or her license to practice medicine in the State of Colorado; (ii) Maintain in good standing his or her Board Certification in Family Practice; and (iii) Maintain Colorado’s Division of Workers’ Compensation Level II accreditation. c. Services Standards. Physician will perform the Coverage Services in accordance with: (i) All applicable laws, regulations, and policies, of federal, state, and local governmental agencies having valid jurisdiction over the City or Physician — for example, the Colorado Department of Public Health and Environment, the Colorado Board of Medical Examiners, the Centers for Medicare and Medicaid Services, and the Office of Inspector General of the Department of Health and Human Services; and d. Directives. Physician will comply with all lawful directives (not inconsistent with the terms and conditions of this Agreement) issued from time to time by The City of Fort Collins that are relevant to the Coverage Services. 2. Insurance. Physician will maintain basic limits professional malpractice liability insurance, covering all Coverage Services provided pursuant to this Agreement, in amounts not less than $1,000,000 per occurrence and $3,000,000 annual aggregate. This obligation survives for three years following termination or expiration of this Agreement. Contemporaneously with execution of this Agreement the Physician will provide a certificate of insurance DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E - 2 - evidencing the coverage required by this Agreement. Physician will notify The City of Fort Collins immediately in writing of the cancellation or termination of this insurance coverage. 3. Term and Termination. a. Term. The initial term of this Agreement (the "Initial Term") commences on the date stated in the introductory clause and continues for a period of one year and will automatically renew for successive one-year terms unless terminated by either party. b. Termination Without Cause. Either party may terminate this Agreement at any time without cause upon 60 days written notice to the other party. c. Termination for Cause. Either party may terminate this Agreement upon a material breach by the other party upon thirty (30) days written notice to the other party, unless the breach is cured by the breaching party to the reasonable satisfaction of the non-breaching party within ten (10) days of written notice. 4. Compensation to Physician. a. Amount. The City of Fort Collins will pay to the Physician $175 per hour for Coverage Services prorated to fifteen minutes units. b. Invoices. On or about the fifth day of each month, Physician will submit a written record of the hours (Attachment B) that he or she actually provided Coverage Service for the prior month. The City of Fort Collins will make payment to Physician within 30 days of receiving this written record. 5. Assignment and Billing. a. Upon the written request of Physician during the Term of this Agreement, the City of Fort Collins will provide Physician unrestricted access, at reasonable times, to claims submitted by the City of Fort Collins for Coverage Services as reasonably required in the performance of this Agreement. 6. Compliance with Regulations. a. Pursuant to Title 42 of the United States Code and applicable rules and regulations thereunder, until the expiration of four years after the termination or expiration of this Agreement, Physician will make available, upon appropriate written request by the Secretary of the United States Department of Health and Human Services or the Comptroller General of the United States General Accounting Office, or any of their duly authorized representatives, a copy of this Agreement and such books, documents and records as are necessary to certify the nature and extent of the costs of the Coverage Services provided Physician under this Agreement. b. The amounts to be paid under this Agreement represent the fair market value of the Services to be provided, as established by arms length negotiations by the parties, and have not been determined in any manner that takes into account the volume or value of any potential referrals between the parties. No amount paid under this Agreement is intended to be, nor should be construed to be, an inducement or payment for referral of patients by either party to the other party. In addition, the amounts charged under this Agreement do not include any discount, rebate, kickback, or other reduction in charges, and the amounts charged DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E - 3 - are not intended to be, nor should they be construed to be, an inducement or payment for referral of patients by either party to the other party. 7. HIPAA Compliance. Physician, by virtue of his or her membership on the City of Fort Collins medical staff, is part of an “Organized Health Care Arrangement” (as defined by the HIPAA Privacy and Security Rules) with The City of Fort Collins. Physician will follow the City of Fort Collins privacy and security policies and procedures. 8. City Records and Confidential Information. a. All records or other documentation that Physician creates in the course of providing the Coverage Services are the property of The City of Fort Collins and not of Physician. The City of Fort Collins will make these records available to Physician as reasonably necessary for treatment and payment purposes. b. When this Agreement expires or terminates, Physician may not take or retain — without prior written permission of The City of Fort Collins — any records of the City of Fort Collins, including any copies. This includes patient records, patient lists, financial records, and business plans. c. Except as permitted by The City of Fort Collins in writing or as required by law, Physician may not disclose to any person or entity any of the City of Fort Collins Confidential Information. For purposes of this Agreement, Confidential Information means: (i) Billing and other financial information, such as charges; (ii) Volume data, such as patient volumes by facility, zip code, payer, payer type, drug, or procedure; (iii) Work processes; (iv) Policies and procedures; (v) Software created by or on behalf of, or modified by or on behalf of, the City; (vi) Business and marketing data and plans; (vii) Patient information and records; (viii) Records and other documents created by Physician in the course of providing the Coverage Services; and (ix) Any other information that the City of Fort Collins marks as confidential or states in writing is confidential. d. The provisions of this Section survive the termination or expiration of this Agreement. 9. Independent Contractor Status. a. This Agreement does not constitute the hiring of Physician as an employee of The City of Fort Collins. The parties agree that the relationship of Physician to The City of Fort Collins while this Agreement is in effect is that of independent contractor. DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E - 4 - b. The Physician acknowledges that he or she is not entitled to any employment rights or benefits of The City of Fort Collins. c. Nothing contained in this Agreement constitutes the City of Fort Collins or Physician as members of any partnership, joint venture, association, syndicate, or other entity. d. Nothing contained in this Agreement grants or confers on the City of Fort Collins or Physician any express, implied or apparent authority to incur any obligation or liability on behalf of other party (unless otherwise agreed to in writing by both parties). e. Physician is solely responsible to pay all applicable taxes, as well as any employee benefits or obligations made necessary by reason of Physicians performance of Services for the City of Fort Collins. 10. Assignment. No party may assign this Agreement without the prior written consent of the other party. 11. Indemnification. a. Each party is responsible for its own acts and omissions and those of its respective agents. Nothing in this Agreement shall create any new or additional right of action against the other party. b. No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections, or other provisions, of the Colorado Governmental Immunity Act, CRS §24-10-101 et seq., or the Federal Tort Claims Act, 28 U.S.C. §§1346(b) and 2671 et seq., as applicable now or hereafter amended. 12. Notices. All notices, requests, demands and other communications required or permitted under this Agreement are sufficient if hand-delivered, sent by first class mail, postage prepaid, or delivered by national overnight delivery service, delivery charges prepaid and addressed as set forth below: Physician: Fredrick Scherr 2618 Quail Creek Rd. Broomfield, Co 80023 City: City of Fort Collins SSRM 215 N Mason St. Fort Collins, CO 80522 Any party may alter the address to which communications or copies are to be sent by giving notice of such change of address to the other party, in conformity with the provisions of this Section for the giving of notice. Notices hand delivered are deemed given on the day so hand delivered; notices given by mail are deemed given on the third business day after mailing; and notices given by national overnight delivery service are deemed given on the next business day after delivery to the service. DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E - 5 - 13. Prohibition Against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et. seq., Service Provider represents and agrees that: a. As of the date of this Agreement: 1. Service Provider does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Service Provider will participate in either the e-Verify program created in Public Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108th Congress, as amended, administered by the United States Department of Homeland Security (the “e-Verify Program”) or the Department Program (the “Department Program”), an employment verification program established pursuant to Section 8-17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired employees to perform work under this Agreement. b. Service Provider shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or knowingly enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien to perform work under this Agreement. c. Service Provider is prohibited from using the e-Verify Program or Department Program procedures to undertake pre-employment screening of job applicants while this Agreement is being performed. d. If Service Provider obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Service Provider shall: 1. Notify such subcontractor and the City within three days that Service Provider has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and 2. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to this section the subcontractor does not cease employing or contracting with the illegal alien; except that Service Provider shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E - 6 - e. Service Provider shall comply with any reasonable request by the Colorado Department of Labor and Employment (the “Department”) made in the course of an investigation that the Department undertakes or is undertaking pursuant to the authority established in Subsection 8-17.5-102 (5), C.R.S. f. If Service Provider violates any provision of this Agreement pertaining to the duties imposed by Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If this Agreement is so terminated, Service Provider shall be liable for actual and consequential damages to the City arising out of Service Provider’s violation of Subsection 8-17.5-102, C.R.S. g. The City will notify the Office of the Secretary of State if Service Provider violates this provision of this Agreement and the City terminates the Agreement for such breach. 14. Miscellaneous. a. Binding Effect. This Agreement is binding upon and inures to the benefit of the parties and their respective successors and permitted assigns. b. Severability. The invalidity or unenforceability of any provision of this Agreement does not affect the validity or enforceability of any other provision. c. Governing Law. This Agreement will be construed and enforced in accordance with the internal laws of the State of Colorado, without consideration of conflict of laws principles. d. Non-Appropriation. To the extent this Agreement or any provision in it constitutes a multiple fiscal year debt or financial obligation of the City, it shall be subject to annual appropriation by City Council as required in Article V, Section 8(b) of the City Charter, City Code Section 8-186, and Article X, Section 20 of the Colorado Constitution. The City shall have no obligation to continue this Agreement in any fiscal year for which no such supporting appropriation has been made. e. Entire Agreement. This Agreement represents the entire agreement between the parties with respect to its subject matter. This Agreement supersedes all prior agreements and understandings with respect its subject matter. No amendment of this Agreement is enforceable against any party unless the amendment is in writing and the party against whom enforcement is sought has signed the amendment. The parties agree that this Agreement does not conflict with any other prior agreements between the parties that do not relate to the subject matter of this Agreement. f. Section Headings. The section headings in this Agreement are for convenience of reference only and do not affect the construction or interpretation of any provision of this Agreement. DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E - 7 - g. Execution in Counterparts. This Agreement may be executed in any number of counterparts, each of which is an original as against any party whose signature appears on the counterpart. Multiple, separately signed counterparts taken together constitute one and the same instrument. This Agreement is binding when one or more counterparts of it, individually or taken together, bear the signatures of all of the parties. The undersigned are executing this Agreement on the date stated in the introductory clause. City of Fort Collins _________________________________ Gerry Paul, Director Purchasing ATTEST: _________________________________ City Clerk APPROVED AS TO FORM: ________________________________ Senior Assistant City Attorney Physician: _________________________________ Fredrick Scherr MD DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E No new insurance required - 8 - Attachment A Coverage Services and Service Standards 1. Coverage Services. Physician will provide the following services (the “Coverage Services”) for adult patients (patients 18 years or age or older): a. Provide direct clinical services for C.O.M.P. patients based on Colorado Division of Workers’ Compensation Treatment Guidelines; b. Provide guidance for cases that fall outside the Workers’ Compensation Treatment Guidelines and those cases designated by the case manager as "red flags"; c. Provide input regarding the development of medical and operational protocols, policies and procedures to be utilized by the C.O.M.P. Provide medical direction and consultation to the C.O.M.P. staff; d. Communicate with collaborating physicians on a regular basis to monitor adherence to Workers’ Compensation Treatment Guidelines; e. Any other duty as may be reasonably requested by The City of Fort Collins from time to time. 2. Service Standards. In providing the Coverage Services, Physician will: a. Take reasonable steps to enter charges timely; b. Provide and maintain a collaborative agreement with the Occupational Health Professional. c. Provide input regarding the development of medical and operational protocols, policies and procedures to be utilized by The City of Fort Collins. Provide medical direction and consultation to The City of Fort Collins. d. Maintain open communication between the City of Fort Collins staff, administration and medical staff. DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E - 9 - Attachment B Monthly Time Log Monthly Time Log Physician: Coverage for: The City of Fort Collins Occupational Health Program Month: _____________________ Date of Service Patient Name Time Total Hours for Month: _________ For The City of Fort Collins Use ONLY Total Hours: _________ Total Payment: _________ Department #: __________ Account Code: __________ Approved by:________________________ Date:______________ DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E CO-COI 09/01/2010 Post Office Box 17540 Denver, Colorado 80217-0540 (720) 858-6000 1-800-421-1834 FAX (720) 858-6004 CERTIFICATE OF PROFESSIONAL LIABILITY INSURANCE CERTIFICATE HOLDER NAMED INSURED/INSURED GROUP NAME: This certificate is issued as a matter of information only and confers no rights upon the holder. By its issuance the company does not alter, change, modify or extend the provisions of said policy and does not waive any of its rights thereunder. POLICY NUMBER: RETRO DATE: POLICY TERM: to LIMITS OF LIABILITY: Per Medical Incident/Peer Review Incident: Annual Aggregate: SPECIALTY: Dated at: Denver, Colorado Date: Countersigned by Authorized Representative Frederick Paul Scherr Frederick Paul Scherr M.D. 2618 Quail Creek Dr 2618 Quail Creek Dr Broomfield, CO 80023-6540 Broomfield, CO 80023-6540 Frederick Paul Scherr, M.D. PCC0012642 1/13/2014 1/13/2016 1/13/2017 $1,000,000 $3,000,000 FP/GP-Office/Ambulatory 2/17/2016 DocuSign Envelope ID: 57F50685-E388-4FAF-BC30-5BDC53C4736E