Miami-Dade Legislative Item
File Number: 131400
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File Number: 131400 File Type: Resolution Status: Adopted
Version: 0 Reference: R-591-13 Control: Board of County Commissioners
File Name: PHT TO DESIGNATE OUTSIDE COUNSEL MEDICARE GROUP APPEAL Introduced: 7/1/2013
Requester: NONE Cost: Final Action: 7/2/2013
Agenda Date: 7/2/2013 Agenda Item Number: 14A1
Notes: Title: RESOLUTION AUTHORIZING THE PUBLIC HEALTH TRUST TO DESIGNATE THE INDIANAPOLIS LAW FIRM OF HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C. AS OUTSIDE LEGAL COUNSEL TO REPRESENT THE PUBLIC HEALTH TRUST FOR PURPOSES OF PARTICIPATING IN A MEDICARE GROUP APPEAL BEFORE THE PROVIDER REIMBURSEMENT REVIEW BOARD TO CHALLENGE THE ACCURACY OF MEDICARE PAYMENTS RELATED TO PRIOR COST REPORT YEARS WITH CONTINGENCY FEES NOT TO EXCEED ONE MILLION FIVE HUNDRED THOUSAND DOLLARS AND NO/100 ($1,500,000.00)
Indexes: OUTSIDE COUNSEL
  PUBLIC HEALTH TRUST
Sponsors: Audrey M. Edmonson, Prime Sponsor
Sunset Provision: No Effective Date: Expiration Date:
Registered Lobbyist: None Listed


Legislative History

Acting Body Date Agenda Item Action Sent To Due Date Returned Pass/Fail

Board of County Commissioners 7/2/2013 14A1 Adopted P

Office of the Chairperson 7/1/2013 Additions

County Attorney 7/1/2013 Referred Health & Social Services Committee

County Attorney 7/1/2013 Assigned Eugene Shy

Legislative Text


TITLE
RESOLUTION AUTHORIZING THE PUBLIC HEALTH TRUST TO DESIGNATE THE INDIANAPOLIS LAW FIRM OF HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C. AS OUTSIDE LEGAL COUNSEL TO REPRESENT THE PUBLIC HEALTH TRUST FOR PURPOSES OF PARTICIPATING IN A MEDICARE GROUP APPEAL BEFORE THE PROVIDER REIMBURSEMENT REVIEW BOARD TO CHALLENGE THE ACCURACY OF MEDICARE PAYMENTS RELATED TO PRIOR COST REPORT YEARS WITH CONTINGENCY FEES NOT TO EXCEED ONE MILLION FIVE HUNDRED THOUSAND DOLLARS AND NO/100 ($1,500,000.00)

BODY
WHEREAS, the Public Health Trust (“Trust”) is an agency and instrumentality of Miami-Dade County that operates Jackson Health System, including Jackson Memorial Hospital, Jackson South Community Hospital, Jackson North Medical Center and multiple other County designated facilities providing health care services to all segments of the Miami-Dade County community; and
WHEREAS, the Trust is a Medicare provider and has entered into a service agreement with the Centers for Medicare and Medicaid Services (“CMS”) to provide services to Medicare beneficiaries, including inpatient and outpatient services, and receive payment therefore from CMS; and
WHEREAS, CMS implemented a budget neutrality calculation as part of the Balanced Budget Act of 1997; and
WHEREAS, an error in the budget neutrality calculation related to the Inpatient Prospective Payment System was identified beginning in FFY 1999; and
WHEREAS, CMS partially fixed the budget neutrality calculation in FFY 2008 for FFY 2007 but failed to correct the cumulative error from prior years; and
WHEREAS, Baker Healthcare Consulting, Inc., an Indianapolis-based company, has identified the aforementioned error and desires to file a group appeal in concert with Florida Hospital Association seeking payment on the errors occurring in prior years; and
WHEREAS, as an affected Florida Medicare provider, the Trust could elect to participate in the group appeal which would require the Trust to designate the Indianapolis-based law firm of Hall, Render, Killian, Heath & Lyman, P.C. as the Trust’s outside legal counsel with respect to the aforementioned matter; and
WHEREAS, Article 5, Section 5.06 of the Charter, provides that the County Attorney “shall serve as legal counsel to the Board, Mayor, and all county departments, offices, and agencies”; and
WHEREAS, Chapter 25A of the Code provides that the Trust shall utilize the legal services provided by the County Attorney’s Office; and
WHEREAS, Article 5, Section 5.06 of the Charter authorizes the Board to “employ special counsel for special needs”; and
WHEREAS, the Trust seeks to designate Hall, Render, Killian, Heath & Lyman, P.C.as outside legal counsel to represent the Trust in the Medicare group appeal; and
WHEREAS, the estimated favorable adjustment for the Trust upon successful appeal is estimated at $6,800,000.00; and
WHEREAS, the Commission finds it would be in the best interest of the Trust to participate in said group appeal,
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MIAMI-DADE COUNTY, FLORIDA, that this Board hereby authorizes the Public Health Trust of Miami-Dade County to designate the Indianapolis law firm of Hall, Render, Killian, Heath & Lyman, P.C. as outside legal counsel solely for purposes of participating in a Medicare group appeal before the Provider Reimbursement Review Board with contingency fees not to exceed One Million Five Hundred Thousand Dollars and No/100 ($1,500,000.00).



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