HomeMy WebLinkAbout25K - MEDICAL CLAIMS
CITY COUNCIL MEETING DATE:
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REQUEST FOR
COUNCIL ACTION
CLERK OF COUNCIL USE ONLY:
May 1, 2006
TITLE:
APPROVED
o As Recommended
o As Amended
o Ordinance on 1" Reading
o Ordinance on 2" Reading
o Implementing Resolution
o Set Public Hearing For
AMENDED AGREEMENT FOR MEDICAL
CLAIMS COMPENSATION COST
CONTAINMENT PROGRAM
~ar.
CI MANAGER
CONTINUED TO
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FILE NUMBER
RECOMMENDED ACTION
Direct the City Attorney to prepare and authorize the City Manager and the
Clerk of the Council to execute an amendment to the agreement with Lien on
Me, Inc. to provide a workers' compensation medical cost containment
program in an annual amount not to exceed $200,000.
DISCUSSION
The City has utilized the services of Lien on Me, Inc. (LOM) since August
2000 for medical cost containment. LOM reviews all of the medical bills
submitted to the City for workers' compensation treatment. These
numerically coded bills are then reviewed to the current fee schedule
established by the Administrative Director of the Division of Workers'
Compensation and reduced accordingly. This complex process results in a
monthly savings between 30 and 50% of that originally billed by medical
providers.
Since the original agreement, the State of California has implemented a
new fee structure for hospital billings. The proposed amendment
establishes a rate structure for services to review bills under the new
rates. The Department of Insurance has established a training and
certification program for medical bill reviewers. This agreement requires
that the provider comply with the regulations. The amended agreement will
not significantly affect the existing costs of the program.
25K-1
Amended Agreement for Medical Claims
May 1, 2006
Page 2
FISCAL IMPACT
Budgeted funds are available in the FY 2005-06 Workers' Compensation
Contractual Services Account (account no. 82-178-6291).
APPROVED AS TO FUNDS AND ACCOUNTS:
Agency
':\(\(\."'~~('.\ ~~_.
Francisco Gutierrez
Executive Director
Finance & Management service~
25K-2