HomeMy WebLinkAbout11866RESOLUTION NO. 11866
A RESOLUTION APPROVING AN AGREEMENT
BETWEEN PUEBLO, A MUNICIPAL CORPORATION, AND
AMERICAN MEDICAL RESPONSE, INC. CONCERNING
EMERGENCY MEDICAL TECHNICIAN SERVICES
WHEREAS, the Fire Department has negotiated an Agreement with American
Medical Response, Inc, providing for Fire Department EMTs and paramedics to provide
medical services to AMR for the benefit of ambulance patients, providing that AMR shall
compensate the City for these services, and setting forth terms and conditions; and
WHEREAS, the proposed Agreement will promote the health, safety and welfare
of the residents of and visitors to Pueblo, and
WHEREAS, the Fire Department believes that proposed Agreement is in the best
interests of the City and has recommended that the proposed Agreement be approved
by City Council; and
NOW, THEREFORE, be it resolved by the City Council of Pueblo, that:
SECTION 1
The proposed Agreement between the City of Pueblo and American Medical
Response, Inc., dated April 15, 2010, a copy of which is attached to this Resolution as
Exhibit 'A" having been approved as to form by the City Attorney, is hereby approved.
SECTION 2
The President of City Council is authorized and directed to execute the
Agreement for and on behalf of the City and the City Clerk is directed to attest the
same.
INTRODUCED: April 12, 2010
BY: Ray Aquilera
COUNCILPERSON
APPROVED:
RESIDENT CF CITY CC) UNCIL
ATTESTED BY:
GIB' Y CLERK
Background Paper for Proposed
RESOLUTION
AGENDA ITEM # S -1
DATE April 12, 2010
DEPARTMENT Fire Department — Christopher P. Riley
Law Department
TITLE:
A Resolution Approving an Agreement between Pueblo, a Municipal Corporation and American
Medical Response, Inc. concerning Emergency Medical Technician Services.
ISSUE
Should the City enter into an agreement with American Medical Response, Ina.( "AMR ")
providing that AMR will compensate the City for the services of Fire Department EMTs and
Paramedics who provide emergency medical services to patients in AMR ambulances en route to
hospitals?
RECOMMENDATION
The proposed Agreement should be approved.
BACKGROUND
American Medical Response, Inc. ( "AMR ") is the primary ambulance provider within the City,
(but does not have an exclusive right to provide ambulance services within the City). Fire
Department EMTs and paramedics respond to the same medical emergencies as AMR.
Fire Department EMTs and paramedics accompany AMR EMTs and paramedics on ambulance
trips to the hospital when the patient's injuries require the services of two EMTs or paramedics.
During the time that the Fire Department Crew Member accompanies the AMR EMT or
paramedic, the Fire Department Crew Member, his or her fire truck, and the two other Fire
Department Crew Members are placed out of service and cannot respond to other emergency
calls.
Under the current practice, AMR and the patients on AMR ambulances have received the benefit
of the Fire Department's EMT or paramedic on AMR ambulance trips free of charge. In
addition, the legal relationship of the two EMTs, insurance, indemnity, and other issues have
never been addressed.
Under the proposed Agreement, the practice described above would continue, but AMR would
compensate the City for the services of Fire Department Crew Members. The Agreement also
addresses insurance, indemnification, and formalizes the arrangement for replenishment of Fire
Department medical supplies.
FINANCIAL IMPACT
The Agreement is intended to increase general fund revenues by approximately $95,520 each
year.
AMR will pay the City approximately $95,520 for these services each year, which should just
compensate the City for its costs in providing these services. However, at present, the City is not
compensated for these costs. Therefore, the City will realize an increase in general fund revenues
of approximately $95,520 each year.
AGREEMENT BETWEEN THE CITY OF PUEBLO
AND AMERICAN MEDICAL RESPONSE OF COLORADO, INC. CONCERNING
EMERGENCY MEDICAL SERVICES
This Agreement ( "Agreement ") is entered into this 12th day of April 2010, by and
between Pueblo, a Municipal Corporation, ( "City "), and American Medical Response of
Colorado, Inc. ( "AMR ").
RECITALS
A. AMR provides emergency medical services ("EMS Services ") through its EMTs
and Paramedics ( "AMR Personnel ") within the City of Pueblo for the benefit of injured or ill
persons at the scene of medical emergencies.
B. The City provides certain emergency medical technician and paramedic services
within the City through the Pueblo Fire Department's EMT - Basics, EMT - Intermediates and
Paramedics ("Fire Department Members "). The patients so treated are often transported to the
hospital in AMR's ambulances.
C. From time to time, AMR Personnel determine that it is in the best interests of
these patients for Fire Department Members to accompany the patient(s) in AMR's ambulance(s)
to the hospital so that the patient(s) can receive more complete and necessary medical services en
route.
D The City is not legally obligated to provide Fire Department Members to AMR
for such ambulance trips as part of the fire and emergency medical services that the City
provides to residents and visitors to the City. The obligation to provide emergency medical
services in AMR ambulances is solely AMR's responsibility.
E. The City incurs certain costs in providing Fire Department Members to
accompany AMR Personnel and the patient in the ambulance on the way to the hospital. These
include the cost of the Fire Department Members assisting the AMR personnel, the cost of that
Fire Department Member's fire apparatus, which is placed out of service during the ambulance
trip, and the cost of the two other Fire Department Members assigned to the same fire apparatus,
who cannot respond to other emergency calls during the ambulance trip, the costs of controlled
medications that cannot be replenished under DEA strictures, and administrative costs.
F. AMR and the City desire to enter an agreement providing that AMR will fully
compensate the City for: (a) the reasonable value of the services and supplies that the Pueblo Fire
Department and its EMTs provide to AMR for the benefit of the patient; and (b) the direct and
indirect costs that the City will incur in providing such services.
G. Fire Department records show that Fire Department Members accompany AMR
Personnel on AMR ambulance trips on the way to the hospital approximately thirty times each
month. The time that Fire Department Members spend on the ambulance trip, including the trip
itself, bringing the patient into the hospital, giving report at the hospital, replenishing medical
supplies consumed during the trip, and returning to regular service is approximately one hour.
The number of trips and the amount of time on each trip varies, but 30 hours per month is a fair
approximation.
H. The City has calculated the monthly costs of providing Fire Department Members
for such ambulance trips, based on the cost of the Fire Department Members, fire apparatus, trips
of approximately one hour each, approximately of 30 trips per month, and miscellaneous
administrative costs associated with such trips as follows:
(a) One Fire Department Member assisting the AMR Ambulance
@$37.00/hr x 30 hours /month .............. ............................... $1,100.00
(b) Two Fire Department Members @$76.00 /hr x 30 hours /month ............. $2,280.00
(c) One Fire Department apparatus @ $I x 30 hours /month ................. $4,500.00
(d) Administrative Costs @ $80.00/ month ............ ............................... $80.00
Total Costs Per Month .............................. ............................... $7,960.00
NOW THEREFORE, in consideration of the foregoing recitals and the mutual promises
contained in this Agreement, the Parties agree as follows:
TERMS AND CONDITIONS
1.0 EMERGENCY MEDICAL SERVICES.
1.1 Licenses and Certifications. AMR, its vehicles and personnel shall comply with all
federal, state and local laws related to licensure and certifications. Without limiting the
foregoing, all personnel, engines, quick response vehicles and ambulances shall be fully licensed
or certified as required by law and shall comply with all licensing, certification or other laws. At
a minimum. AMR on an annual basis will perform a review of its personnel's credentials.
1.2 Ambulance Specifications. AMR shall provide ambulances used to provide AMR's EMS
Services ( "Ambulances "). Each Ambulance shall be licensed and equipped with all supplies and
equipment required by state law and shall be maintained in good working order in accordance
with applicable state maintenance policies and procedures.
1.3 Respond to Requests for EMS Services. AMR shall provide EMS Services twenty -four
hours a day, seven days a week, three hundred sixty -five days a year. AMR's response shall be
without regard to the patient's ability to pay.
1.4 Response Times for EMS Services. The Response Times for EMS Services shall be as
follows:
Urban area EMS Ambulance Arrival less than 8 minutes 1 second
Suburban area EMS Ambulance Arrival less than 12 minutes 1 second
For each area, AMR shall arrive within these Response Times ninety percent (90 %) of the time
as measured on a monthly basis.
1.5 AMR Right to Bill. AMR shall be solely entitled to perform and be responsible for
performing all billing of patients and third party payers for EMS Services provided hereunder.
AMR shall comply with all applicable laws governing billing and collection, including but not
limited to laws and regulations applicable to patients covered by Medicare, Medicaid, Tricare
and other public or private reimbursement programs. The City shall not bill for any EMS
Services.
1.6 Measuring Response Times for EMS Services. Response Times for EMS Services will be
measured from the time the dispatch is received by the EMS Ambulance with all information
necessary to respond to the call until the time the EMS Ambulance arrives on -scene (or in the
case of a location other than the actual scene, the staging area or nearest accessible point for the
ambulance, e.g., fence, apartment complex parking lot).
1.7 Courtesy Standby Services for Emergency Incidents. Upon request by City police, fire or
dispatch personnel, and if resources are available, AMR shall furnish courtesy Standby Services
at emergency incidents involving a potential danger to City personnel or the general public at no
charge to the City. Once dedicated to an incident, the EMS Ambulance shall not be removed
from the incident until released by the Incident Commander. EMS Ambulances providing
emergency medical standby coverage at an event or incident to which they are dedicated shall be
available for responses only at the event or incident.
1.8 Classes. As a system enhancement and to improve patient care, AMR will permit Fire
Department personnel to participate in classes that AMR offers to its own employees and AMR
facilities. All Fire Department personnel shall be responsible for the costs of any materials
and /or certification materials. AMR from time -to -time conducts the following classes: CPR, ,
ACLS, PALS, paramedic and EMT refresher courses, IV certification class, Advanced airway
class, Basic and 12 Lead cardiology and /or additional continuing education opportunities.
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2.0 CITY FIRE DEPARTMENT TO PROVIDE EMT AND PARAMEDIC SERVICES
TO AMR IN CERTAIN SITUATIONS.
2.1 The City, through the Pueblo Fire Department, will authorize Fire Department Members
to assist AMR Personnel in providing emergency medical services to patients in AMR's
ambulances en route to hospitals in situations where all of the following conditions are present:
(a) A Pueblo Fire Department apparatus with assigned EMT Basics, EMT -
Intermediates or Paramedics has been dispatched to the scene of a medical or traumatic
emergency within the City of Pueblo;
(b) AMR has dispatched an ambulance to the scene of the same medical or
traumatic emergency within the City of Pueblo;
(c) The patient's medical or traumatic situation requires transportation from the
scene of the emergency to a hospital;
(d) The patient's medical or traumatic situation requires the services of the Fire
Department Member in addition to the AMR Personnel;
(e) AMR Personnel at the scene request that the Fire Department Member
accompany the patient on the trip to the hospital; and
(f) The Pueblo Fire Department Officer in charge at the scene determines, in his
or her sole and absolute discretion, that given the present and anticipated demands on the City's
fire and emergency medical services, the Fire Department Member can be spared for the
ambulance trip, and should accompany the patient in the AMR ambulance to the hospital.
2.2 During the time that the Fire Department Member is assisting AMR on the ambulance
trip, the Fire Department Member shall cooperate with AMR Personnel in providing medical
services to the patient. In the event of a dispute between the AMR Personnel and the Fire
Department Member as to the proper course of drugs, treatment, or other medical procedures
during the ambulance trip, the AMR Paramedic shall have final authority. In no event shall any
physician or AMR Personnel have any authority to require a Fire Department Member to engage
in any practice, treatment, or other medical procedure that is contrary to the rules, regulations,
policies, and protocols of the Pueblo Fire Department or beyond the Fire Department Member's
scope of practice as an EMT or Paramedic.
2.3 This Agreement does not place any obligation or duty whatsoever on the City or the
Pueblo Fire Department to authorize a Fire Department Member to assist AMR in any situation.
This Agreement authorizes the provision of such services in certain situations, but does not
require the same.
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2.4 This Agreement does not place any obligation or duty whatsoever on AMR to utilize the
services of Fire Department Members in any situation. However, if AMR elects to utilize the
services of a Fire Department Member in the situations described in this Agreement, then the
terms of this Agreement shall apply.
2.5 AMR shall not anticipate, staff, or plan its operations based on the availability of Fire
Department Members to provide the services described in this Agreement, and shall not rely
upon the City to provide Fire Department Members to provide emergency medical services to
patients that AMR treats or transports. At all times, AMR shall operate its ambulances and
provide emergency medical services in accordance with all state and federal law, regulations,
and standards of practice for ambulances, EMTs and Paramedics.
3.0 REIMBURSEMENT TO CITY FOR SERVICES PROVIDED.
3.1 For the services provided by the City in Section 2.0, AMR shall pay to the City the
following reimbursement for each full month that this Agreement is in effect: Seven Thousand
Nine Hundred And Sixty Dollars ($7,960). AMR shall pay a pro -rated portion of this sum for
any partial month that this Agreement is in effect. The City warrants and represents that the
payments made by AMR to City shall be less than or equal to the City's actual costs to provide
the services. No funds shall be used by the City in a manner that may violate 42 U.S.C. Section
1320a -7b, the federal Anti - Kickback Statute.
3.2 In addition to these fees, AMR shall, replace and replenish the Fire Department's drugs
and disposable supplies, destroyed, damaged, consumed or contaminated on ambulance trips
with identical or virtually identical drugs, and supplies from AMR's own supplies as long as it is
an item regularly stocked on the AMR ambulance and it is used appropriately based on the
situation. Controlled medications will not be replaced or replenished due to the laws that regulate
their usage.
3.3 AMR may bill the services of the Fire Department Member and the costs of the Fire
Department drugs, supplies and equipment replaced and replenished to the patients who receive
the services of the Fire Department Members, the hospital, the patient's insurer, third -party
payers, and governmental payers, or such other persons as it deems appropriate, at a rate that
AMR determines is fair, appropriate and consistent with all applicable laws and regulations.
3.4 AMR shall be obligated to pay the fees and costs provided in this Agreement to the City
whether or not AMR bills the patient or any third party for the services of the Fire Department
Members and whether or not such bill is paid.
3.5 AMR shall remit the reimbursement stated in this Section 3.0 to the City, without any
billing or invoicing, by no later than the 10th day of each month, for the services provided by the
City in the preceding month. Reimbursement not paid by the 10th day of each month shall bear
interest at the legal rate provided in § 5 -12 -101, C.R.S.
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4.0 NON - EXCLUSIVE AGREEMENT.
4.1 This Agreement does not grant to AMR any exclusive right to utilize the services of Fire
Department Members in the manner described in this Agreement.
4.2 This Agreement does not grant to AMR any exclusive right to provide ambulance or
EMS services on 911 calls or otherwise within the City of Pueblo. Other ambulance companies
and EMS service providers are free to operate within the City of Pueblo provided that they
comply with all federal, state and county regulations regarding such services.
4.3 This Agreement does not impose on the City any obligation on the City to provide EMT
assistance only or exclusively to AMR. The City may, in its sole and absolute discretion, enter
into the same or similar agreements, with similar fees and requirements, with other companies
providing ambulance or emergency medical services within the city of Pueblo.
5.0 INSURANCE AND ACCREDITATION.
5.1 AMR shall, at its own expense, keep in full force and effect during the term of this
Agreement, and during the term of any extension, renewal, or amendment of this Agreement,
commercial general liability insurance against liability to ambulance patients and any other
person, for personal injuries and property damage, including but not limited to death, injury,
illness, and damages of any nature or kind whatsoever, caused by, related to, or in any way
arising from any action or omission by the City, the assisting EMT, or any Pueblo Fire
Department Officer who authorizes the EMT's assistance to AMR. Said policy shall be in
amount not less than Five Million Dollars ($5,000,000) per occurrence and in the aggregate and
shall name the City, its officers and employees as insured parties and waive rights of subrogation
against the City, its officers, and employees.
5.2 AMR shall, at its own expense, keep in full force and effect during the term of this
Agreement, and during the term of any extension, renewal, or amendment of this Agreement,
insurance required under the Colorado Workmen's Compensation Act.
5.3 Within ten days after execution of this Agreement by the last of the Parties to sign, AMR
shall provide the City with a Certificate of Insurance and copies of insurance policies complying
with the insurance and indemnification provisions in this Agreement. AMR shall provide
additional or renewed copies of the Certificates of Insurance and policies upon thirty days
written notice from the City. In the event that either of the insurance policies that AMR is
required to maintain under this Agreement is cancelled or terminated, AMR shall immediately
notify the City in writing and procure replacement policies forthwith, furnishing the City with
copies of the same.
5.4 AMR shall maintain the insurance policies required in this Agreement for at least four
years following the termination or expiration of the term of this Agreement.
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5.5 AMR will maintain CAAS accreditation throughout the term of this Agreement.
6.0 TERM AND TERMINATION.
6.1 The initial three (3) year term of this Agreement shall be from May 1, 2010 through April
30, 2013.
6.2 The City may, in its sole and absolute discretion, renew this Agreement for one or more
additional one -year periods on the same terms stated in this Agreement by giving AMR written
notice of the City's intention to renew at least thirty (30) days before the expiration of the
preceding term. The City may exercise this right to renew for up to two additional one -year
terms.
6.3 Either party may terminate this Agreement during the initial or any subsequent term upon
one hundred twenty (120) days written notice to the other party.
6.4 Either party may terminate this Agreement upon the material breach of this Agreement
by the other party if such breach is not cured within thirty (30) days of written notice thereof to
the other party.
6.5 In the event that this Agreement is terminated or the term of this Agreement expires, the
City will cease providing EMT assistance to AMR. However, all other obligations under this
Agreement shall survive termination or the expiration of this Agreement's term, including but
not limited to AMRs obligations to compensate and reimburse the City, to maintain insurance,
and to indemnify the City and its employees.
7.0 ADDITIONAL DOCUMENTS OR ACTION. The Parties agree to execute any
additional documents or take any additional action that may be necessary to carry out this
Agreement.
8.0 ASSIGNMENT. This Agreement shall not be assigned by AMR without the prior
written consent of the City, which consent may be granted, denied, or conditioned in City's sole
and absolute discretion.
9.0 FORCE MAJEURE. Any delays in or failure of performance by any party of its
obligations under this Agreement shall be excused if such delays or failure are a result of acts of
God, fires, floods, storms, lightning strikes, labor strikes, labor disputes, accidents, regulations or
orders of civil or military authorities, shortages of labor or materials, or other causes, similar or
dissimilar, which are beyond the control of such party.
10.0 BINDING EFFECT. This Agreement shall inure to the benefit of and be binding upon,
the Parties, their respective legal representatives, successors, and assigns; provided, however,
that nothing in this paragraph shall be construed to permit the assignment of this Agreement
except as otherwise expressly authorized herein.
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11.0 NOTICES. Any notice required or permitted by this Agreement shall be in writing and
shall be deemed to have been sufficiently given for all purposes if sent by certified mail or
registered mail, postage and fees prepaid, addressed to the party to whom such notice is to be
given at the following address or at such other address as may be subsequently furnished in
writing to the other party:
If to City:
City Manager
City of Pueblo
One City Hall Place
Pueblo, CO 81001
With an additional copy to:
City Attorney
City of Pueblo
503 N. Main St. Suite 20'
CO 81003
If to AMR:
General Manager
American Medical Response of Colorado, Inc.
922 S. Santa Fe Ave.
Pueblo, CO 81006
With an additional copy to:
Legal Department
American Medical Response, Inc.
6200 South Syracuse Way, Suite 200
Greenwood Village, CO 80111
Such notice shall be deemed to have been given when deposited in the regular United States
mail.
12.0 RE- NEGOTIATION UPON CERTAIN EVENTS. In the event that: (1) the City's
costs in providing the services described in this Agreement increase or decrease by more than
15% in any period of six (6) months or more over the figures set forth in the Recitals to this
Agreement; or (2) the average number of trips per month in which Fire Department Members
accompany the patient in AMR ambulances on the way to the hospital increases or decreases by
more than 15% over any period of six months or more; then the Parties shall re- negotiate the
terms of Section 2 of this Agreement. If the Parties cannot successfully re- negotiate such terms,
then either Party may terminate this Agreement in accordance with Section 5.3.
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13.0 PARAGRAPH CAPTIONS. The captions of the paragraphs are set forth only for the
convenience and reference of the Parties and are not intended in any way to define, limit or
describe the scope or intent of this Agreement.
14.0 INTEGRATION, SEVERABILITY, AMENDMENT, AND COUNTERPARTS.
This Agreement represents the entire agreement between the Parties and supersedes all prior
discussions and written agreements or understandings. This Agreement may be amended only
by an instrument in writing signed by the Parties. If any provision of this Agreement is held
invalid or unenforceable, no other provision shall be affected by such holding, and all of the
remaining provisions of this Agreement shall continue in full force and effect. This Agreement
may be executed in multiple counterparts, each of which shall be deemed an original, and all of
which together constitute one and the same agreement.
15.0 NO THIRD PARTY BENEFICIARIES; NO WAIVER OF IMMUNITIES. Nothing
in this Agreement is intended, nor should it be construed, to create any rights, claims, or benefits
or assume any liability for or on behalf of any third party, or to waive any immunities or
limitations conferred under federal or state law, including but not limited to the Colorado
Governmental Immunity Act, § 24 -10 -101 et seq., C.R.S.
16.0 DEFAULT. In the event that this Agreement is breached, the aggrieved party's sole
remedy shall be to terminate this Agreement and neither party shall be entitled to legal or equitable
relief for such default. However, despite default and despite termination, the City may seek legal
remedies to recover any fees or reimbursement due to the City for services rendered and drugs,
supplies, and equipment furnished under this Agreement before termination of this Agreement.
17.0 WAIVER OF BREACH. A waiver by any party to this Agreement of the breach of any
term or provision of this Agreement shall not operate or be construed as a waiver of any
subsequent breach by either party.
18.0 GOVERNING LAW AND VENUE. This Agreement shall be governed by the laws of
the State of Colorado. Venue for any action arising under this Agreement or for the enforcement
of this Agreement shall be in a state court with jurisdiction located in Pueblo County, Colorado.
19.0 INDEMNIFICATION. AMR expressly agrees to indemnify, hold harmless, and defend
the City and its officers or employees against any and all claims, demands, suits, actions,
penalties, damages, liability, judgments, disputes, penalties, and administrative sanctions,
including costs and attorney's fees, that are or may be adjudged, granted, or awarded as a result
of any action or omission by AMR, its employees, any Fire Department Member assisting AMR,
or any Fire Department Officer authorizing the EMT's assistance to AMR, in performing any
work in any way related to or pursuant to this Agreement. In the event that any such suit or
action is brought against the City, the City will give reasonable notice thereof to AMR.
20.0 FUND AVAILABILITY. Financial obligations of City, if any, after the current year in
which this Agreement is signed by both parties are contingent upon funds for that purpose being
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appropriated, budgeted and otherwise made available by Pueblo City Council and City executive
departments. Nothing herein shall be deemed to create an ongoing financial obligation of City.
21.0 NO MULTI -YEAR FISCAL OBLIGATION ON CITY. This Agreement is expressly
made subject to the limitations of the Colorado Constitution. Nothing herein shall constitute, nor
deemed to constitute, the creation of a debt or multi -year fiscal obligation or an obligation of
future appropriations by the City Council of Pueblo, contrary to Article X, § 20 Colorado
Constitution or any other constitutional, statutory or charter debt limitation. Notwithstanding any
other provision of this Agreement, with respect to any financial obligation of the City which may
arise under this Agreement in any fiscal year after 2010, in the event the budget or other means
of appropriations for any such year fails to provide funds in sufficient amounts to discharge such
obligation, such failure shall not constitute a default or breach of this Agreement, including any
sub - agreement, attachment, schedule, or exhibit thereto, by the City.
22.0 AUTHORITY OF SIGNERS. Each person signing this Agreement on behalf of a party
represents and warrants that he or she has the requisite power and authority to enter into, execute,
and deliver this Agreement on behalf of such party and that this Agreement is a valid and legally
binding obligation of such party enforceable against it in accordance with its terms.
23.0. RELATIONSHIP. Nothing in this Agreement is intended to, or shall be deemed to
constitute, a partnership or joint venture between the Parties, or to create any agency or partner
relationship between the Parties. Neither Party shall hold itself out as a partner, joint venture,
agent, or representative of the other under this Agreement.
24.0 COMPLIANCE. The parties will comply in all material respects with all applicable
federal and state laws and regulations including, the federal Anti - kickback statute.
25.0 COMPLIANCE PROGRAM AND CODE OF CONDUCT. AMR has made available
to each party a copy of its Code of Conduct, Anti - kickback policies and other compliance
policies, as may be changed from time -to -time, at AMR's web site, located at: www.amr.net,
and each party acknowledges receipt of such documents. AMR warrants that its personnel shall
comply with AMR's compliance policies, including training related to the Anti - kickback Statute.
26.0 NON - EXCLUSION. Each party represents and certifies that neither it nor any
practitioner who orders or provide Services on its behalf hereunder has been convicted of any
conduct that constitutes grounds for mandatory exclusion as identified in 42 U.S.C.§ 1320a -7(a).
Each party further represents and certifies that it is not ineligible to participate in federal health
care programs or in any other state or federal government payment program. Each party agrees
that if DHHS /OIG excludes it, or any of its practitioners or employees who order or provide
Services, from participation in Federal health care programs, the party must notify the other party
within five (5) days of knowledge of such fact, and the other party may immediately terminate
this Agreement, unless the excluded party is a practitioner or employee who immediately
discontinues ordering or providing Services hereunder.
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27.0 REFERRALS. It is not the intent of either party that any remuneration, benefit or
privilege provided for under the Agreement shall influence or in any way be based on the referral
or recommended referral by either party of patients to the other party or its affiliated providers, if
any, or the purchasing, leasing or ordering of any services other than the specific services
described in this Agreement. Any payments specified herein are consistent with what the parties
reasonably believe to be a fair market value for the services provided.
[Signature page follows]
DATED this 12th day of April ' 2010.
PUEBLO. a Municipal Corporation
)L
President of City Council
ATTEST:
�. zZ�'r"
City rk
APPROVED AS TO FORM:
City Atto
AMERICAN MEDICAL RESPONSE OF COLORADO, INC.
Name: Sco Lean
Title: G eral Manager
ATTEST:
12