Loading...
2000-23445 RESORESOLUTION NO. 2000-23445 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, AMENDING RESOLUTION NO. 92- 20593 INCREASING THE PRESENT FIRE RESCUE TRANSPORT FEES FROM $175 FOR BASIC LIFE SUPPORT, AND $290 FOR ADVANCED LIFE SUPPORT, TO $310 FOR BASIC LIFE SUPPORT, AND $310 FOR ADVANCED LIFE SUPPORT; ESTABLISHING A MILEAGE CHARGE OF $7.50 PER MILE; AND INCREASING THE CHARGE FOR MEDICAL OXYGEN FROM $25 TO $30 PER INTERVENTION. WHEREAS, it is necessary to raise the established Fire Rescue Transport Fees for Basic Life Support and Advanced Life Support, due to increased operation expenses and to become uniform with Miami-Dade County Rescue Services; and WHEREAS, the present rates for said services are $175 for Basic Life Support and $290 for Advanced Life Support Transports; and and WHEREAS, a fee for transport mileage of $7.50 per mile transported shall be established; WHEREAS, the increased fees for said services and increased charges for expendable medical supplies shall be as follows: and; Advanced Life Support Basic Life Support Mileage Charge / PER Mile Oxygen $310.00 $310.00 $ 7.50 $ 30.00 WHEREAS, notwithstanding the above fees, no individuals shall be deprived of Fire Rescue Transport Services due to the inability to pay for such services. BE IT DULY RESOLVED BY MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the present Fire Rescue Transport Fees be increased from $175 for Basic Life Support, and $290 for Advanced Life Support, to $310 for Basic Life Support, and $310 for Advanced Life Support; establishing a mileage charge of $7.$0 per mile; and increasing the charge for medical oxygen from $25 to $30 per intervention. PASSED AND ADOPTED this 12th day of January ,2000 ATTEST: CITY CLERK MAYOR LL\MDB~F~ED~(~J} C\FircRescu¢\ComjMemo & Reso. Fee Increase APPROVED AS TO FORM & LANGUAGE & FOR EXECUTION CITY OF MIAMI BEACH /NTERNA£ AUDIT REPORT DATE: TO: VIA: FROM:,' July 9, 1999 Sergio Rodriguez, City Manager Mayra Diaz Buttacavo/i, Assistant City Manager James J. Sutter, internal Auditor SUBJECT: Fire Rescue Fees PERIOD: October 1, 1997 through May 31, 1999 iNTRoDUCTION The Fire Rescue Division of the Fire Department is responsible for providing emergency medical transport service in accordance with Resolution 92-20:593. Thi.~ resolution provides that the City charge $1:50 for Basic Life Support (BLS) and $250 for Advance Life Support (ALS) for each transport. On Suly 26, 1995, the City Commission passed and adopted an increase in the rescue fees to $175 for (BLS) and $290 for (AL~. The Metro Dade County Commission subsequently approved this increase and became effective on November 7, 1995. City Commission Memo No. 359-94 of May 18, 1994 awarded a one year contract to Advance Data Processing, lac., to provide emerg~ medical transport billing and collection services for the City, with an option for two additional years at the City Manager's discretion. The two years ended on September 30, 1997 and ADP has been operating without a contract for the past 21 months. The Fire Rescue Division provides the Contractor (ADp) with a daffy list of the number of transports, along with the transpo~ individuals' names and addresses for billing purposes. The contractor is also responsible for follow-up, collection and reporting activities. Revenues collected for Fiscal Year 97/98 were $1,209,145. For the eight month period ending May 31,1999, revenues amount to $757,104. Page 1 of 4 Pages INTERNAL AUDIT REPORT FIRE RESCUE FEE REVENUE OVERALL OPINION AND SUMMARY OF FINDINGS July 9. 1999 The Contract expired on September 30, 1997 and there has been no communication by the City to the Contractor on whether the City intends to exercise its option to renew the agreement or have a new RFP sent out for the service. It is recommended that the City immediately act accordingly to either renew or rebid this agreement. ' All disp .,a~h forms and invoices tested were properly authorized, accounted for and fees charged were correct and in compliance with the City Re~olution. All collections were correctly and timely deposited in the lockbox. ADP correctly bills for the 7% of prior months collections. Follow up efforts to collect unpaid amounts were reasonable before they were written-off. The Finance department reconciles on a monthly basis, the lockbox to the Finaqcial Management System. No exception were noted. Overpayment made by insurance companies or individuals were correctly and timely returned and recorded in the Financial Management System. The minimum reimbursement allowed by Medicare and Medicaid is much lower for the City of Miami Beach, as compared to the minimum reimbursement to Miami Dade County and other near by municipalities. In addition, the City's fees for such service are lower than other near by municipalities. SCOPE e e Confirm that the City is timely providing ADp with the names, addresses and amounts for billing for each person transported by a rescue vehicle, and that these documents are picked up by an authorized representative of ADP once a week, and that ADP initiates billing within five days of receipts of these documents. Confu-m that the City Fire Rescue Division is reconciling the number of billings provided to ADP with the number ADP actually bins. Confmn that ADP is taking timely and appropriate follow-up action on delinquencies and is mailing additional invoices to collect amount due. Confirm that ADP is adhering to the lockbox agreement and all collections for services e INTERNAL AUDIT REPORT FIRE RESCUE FEE REVENUE billed by ADP are deposited into the approved bank lockbox. July 9. 199~ Confirm that ADP has properly calculated and the City correctly paid the monthly collection fee of 7%. Confirm that daily collections were correctly timely recorded in the City's Financial Management System. .. ~onHxm that collections are reconciled monthly with' the City's Financial Management System. FINDINGS, RECOMMENDATIONS, AND MANAGEMENT RESPONSES The agreement with ADP to provide emergency medical transport billing and collection services for the City, expired on September 30, 1997. The Contractor has been operating since without an agreement. Both the Fire Department and the Finance department, are very pleased with ADP's performance and the cooperation they receive from the Contractor. Recomm~_ndntJon The Fh'e Departmem should renew the Contract with ADP as soon as poosible or send out new request for proposals for these services. Management Res'p_ ons~ Chief Jordan has indicated that the Fire Department is already working on renewing the contract with ADP, with the Procurement Department. Internal Audit reviewed the billing and collection process and noted the even though an increase has been received from Medicaid since the last audit it is still much lower than near by municipalities. It was also determine that the City of Miami Beach charges less than Miami Dade County and other near by municipalities for the ALS and BLS. Currently Miami Dad, County is charging $310 for ALS and BLS. The City of Miami is increasing'their fee to the $310 level. We are currently charging $175 for (BLS) and $290 for (ALS). Miami Dad, County as well as the City of Miami charge $7.50 per mile for additional revenues, Page 3 of 4 Pages INTERNAL AUDIT REPORT FIRE RESCUE FEE REVENUE Julv 9. 1999 whereby the City does not cJ~u'§e for mileage which may result is some additional revenue. Recommendation The Fire Depar~ent should comact the Medicare Education aad Outreach to negotiate aa increase ia ~he fees paid by Medicare. Also, the Fire Depar~ent may want to propose iacreasia§ ALS and BLS fees to the City Commission for approval, to be competitive with other municipalities. % l~/anaeement Response The Fire Department has indicated thut they have spoken to Medicare Education and Outreach to discuss increasing the fees paid by Medicare. However, Medicare informed the Fire Department that since the City recently got aa increase in the fees, they must wait a year before reapplying. The Fire. Department has indicated that they will be going ia front of Commission for approval on the increase of ALS and BLS fees. Closing Conference. A closing conference was held on Friday, June 9, 1999 in the Internal Audit deparUnent. Attendees were Floyd Jordan Fire Chief; Ed DelFavero, EMS Chief; James Sutter, Internal Auditor; and Laura Franco-Rubines, Senior Auditor. Findings and management's responses included above were discussed at the closing meeting. $$S:LF:ff (Audit Performed by Laura Franco, Senior Auditor) (fireresc.wpd) 98/99 Floyd Jordan, Fire Chief Ed Delfavero, EMS Division Chief Bill Gonzalez, Financial Analyst IH Page 4 of 4 Pages MUNICIPALITIES The Miami-Dade Fire Rescue Department serves unincorporated Dade County and 25 municipalities. ,'l~bse municipalities are: Aventura Bal Harbour Bay Harbor Islands Biscayne Park El Portal Florida City Golden Beach Hialesh Gardens Homestead Indian Creek Islandla Medley Miami Shores Miam~ North Bay Village North Miami North Miami Beach Opa-locka Pinecrest South Miami Surfside Swestwater Sunny Isles Beach Virginia Gardens West Miami HOME htrp://www, co.miami-dade.fl.us/fh-erescue/rnunicipalities.hUn 9/23/99 MUNICIPALITIES The Miami-Dade Fire Rescue Department serves unincorporated Dade County and 25 municipalities. These municipalities are: Aventura Bal Harbour Bay Harbor Islands Biscayne Park El Portal Florida City Golden Beach Hialeah Gardens Homestead Indian Creek Islandia Medley Miami Shores Miami Sl~rings North Bay Village North Miami North Miami Beach Opa-locka Pinecrest South Miami Surfside Sweetwater Sunny Isles Beach Virginia Gardens West Miami HOME rl top ofpa~e I http://www.co.miami-dade.fl.us/firerescue/municipalities.htm 9/23/99 MUNICIPALITIES The Mlami-Dade Fire Rescue Department serves unincorporated Dade County and 25 municipalities. Thtme municipalities are: Aventura Bal Harbour Bay Harbor Islands Biscayne Park E! Portal Florida City Golden Beach Hialeah Gardens Homestead Indian Creek Islandia Medley Miami 8heres North Bay Village Neigh Miami North Mhmi Beach Opa-iockn Pinecr~t South Miami 8urhide 8westwater Sunny hies Beach Virginia Gardene West Miami 9/23/99 Attachment Rescue Transport Billing Increase Request · Original City of Miami Beach Commission Resolution requiring a fee for transports: 92-20593. · Amendment of City of Miami Beach Commi.~sion Resolution requiring a fee for transport: 95-21653. · Comparison of other ckies Rescue Transport Billing; see separate attachment. · Current Medicare collection caps for the City oflVliami Beach: BLS - 175.00 ALS - 203.62 Cap for our area 292.95 Medicare pays 80% of above amounts. · Medicade Caps for our area. Cap is the same for all in this area. BLS- 136.00 ALS- 190.00 Medicade pays 100 % of above for covered persons. Will pay 20% of Transport fee if covered by both Medicare and Medicade. · Audit Report by City of Miami Beach - see separate attachment Collection Rates for other Fire Departments in Miami Dade County: Miami 59% Miami Dude 63% Hialeah 72% Coral Gables 60% Miami Beach 65% Cost of Rescue Division Operations for the City of Miami Beach and Revenue generated by Rescue Transports: Operatln~ Budget 1220 Division: $7,105,522 Revenue fi~om TranSports: $1,2 00,000 CITY OF MIAMI BEACH CITY HALL 1700 CONVENTION CENTER DRIVE MIAMI BEACH, FLORIDA 33139 http: ~\ci. miami-beach .fl. us COMMISSION MEMORANDUM NO. 2.4-00 TO: FROM: Mayor Neisen O. Kasdin and Members of the City Commission Lawrence A. Lev~ City Manager DATE: January 12, 2000 SUBJECT: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, AMENDING RESOLUTION NO. 95-21653 INCREASING THE PRESENT FIRE RESCUE TRANSPORT FEE FROM $175 FOR BASIC LIFE SUPPORT, AND $290 FOR ADVANCED LIFE SUPPORT, TO $310 FIRE BASIC LIFE SUPPORT, AND $310 FOR ADVANCED LIFE SUPPPORT, AND ESTABLISHING A MILEAGE CHARGE OF $7.50 PER MILE, AND INCREASING THE CHARGE FOR MEDICAL OXYGEN FROM $25 TO $30 PER INTERVENTION. ADMINISTRATION RECOMMENDATION: Adopt the Resolution. ANALYSIS: The Fire Department presently provides medical transportation for persons requiring Basic Life Support (BLS) or Advanced Life Support (ALS) at a rate of $175 per BLS and $290 for ALS transport. (Established by Resolution No. 92-20593 on September 16, 1992, amended July 26, 1995, Resolution No. 95-21653). Since the establishment of the first transportation fee, the Fire Department has experienced increased budgetary costs in providing BLS and ALS transport service, both for medical supplies and increased vehicle maintenance costs. An intemal city audit of our Transport Billing Service, (Advanced Data Processing) confirmed that ADP was meeting or exceeding the terms of their contract (see attachment). In order to increase revenue, the audit report suggested that the City increase transport fees to equal Miami Dade and City of Miami Fire Departments. The proposed increases in transport rates will be consistent with the rate structure of both Miami and Miami-Dade County Fire Departments. (See attached chart indicating Rescue Transport fee structures for other Fire Departments in South Florida). AGENDA ITEM ~-- DATE l--~/'2 ,- The proposed rate increase for expendable medical supplies and transport mileage charge will provide needed revenue to the Fire Department to offset increased budgetary costs. A comparison of the fees charged by the City of Miami Beach and other local governmental entities is attached for your review. If the proposed fee increase is approved for Miami Beach, the fees will be comparable with other entities. The annual budget for the Rescue Division is $7,599,884. Revenue from Rescue Transports is $1,200,000. The revenue increase due to fee adjustments is projected to be approximately $370,000 during FY 99/2000. Medicare will pay 80% of the cap for Miami Beach. Currently, that cap is $175.00 for BLS and $203.62 for ALS Transports. The other 20% is paid by secondary insurance or out of pocket. The cap for Miami and Miami-Dade County is $292.95. This year the City of Miami Beach received the maximum allowable increase of 15%. We will continue pursuing annual increases until we reach the maximum cap of $292.95. A majority of private insurance companies will pay 100% of what is usual and customary of the transportation fee, plus additional charges as listed below, minus applicable deductions. Automobile insurance polices pay 100% provided the policy has P.I.P. coverage. HMO' s will pay 100% of the amount billed. Revenue received from rescue transportation fees consists of 4855 % from private insurance, 31% from Medicare, 13'/2 % from Medicaid and 7% out of pocket. No individual will be denied Fire Rescue transport services due to an inability to pay for such services. The proposed increases are as follows: CMB CMB Present Proposed Advanced Life Support $175.00 $310.00 Basic Life Support $290.00 $310.00 Mileage Charge / PER Mile 0 $ 7.50 Oxygen $25.00 $ 30.00 Cardiac Monitoring $25.00 $ 25.00 I.V. / I.O. $25.00 $ 25.00 Intubation $25.00 $ 25.00 Spinal Immobilization $25.00 $ 25.00 It is recommended that Resolution No. 95-21653, Schedule of Fire Rescue Transport Fees for Fire Department be amended. LLXJ~IlJ~'FJ~ED