HomeMy WebLinkAboutResolution - 2006-R0567 - Contract - Covenant Medical Group - On-Site Medical Services - 11/21/2006Resolution No. 2006-RO567
November 21, 2006
Item No. 5.21
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock BE and is hereby authorized and
directed to execute for and on behalf of the City of Lubbock, a Contract with Covenant
Medical Group for on-site medical services for employees and dependants, which
Contract is attached hereto and incorporated herein as part of this Resolution.
Passed by the City Council this 21st day of November , 2006.
DAVID MILLER., MAYOR
ATTEST:
Reb cca Garza, City Secretary
APPROVED AS TO CONTENT:
Manager
APPROVED AS TO FORM:
D. Mitchell Satterwhite, Assistant City Attorney
gs/ccdocs/Cont Covenant Med Grp -Onsite Med Serv.res
Nov 20, 2006.
Resolution No. 2006-RO567
November 21, 2006
Item No. 5.21
Covenant Medical Group and Covenant Health System
On -Site Medical Services Agreement for Employees and Dependants
This Employer Agreement is made and entered into this lit day of January 2007,
by and between the City of Lubbock ("Employer"), and Covenant Medical Group and
Covenant Health System, a Texas corporation ("CMG/CHS").
Recitals:
A. CMG/CHS contracts with employers to provide physicians or physician
extenders (nurse practitioners or physician assistants) and/or medical assistants at the
employer's place of business to perform certain medical services to the employees of such
employers and/or their dependents.
B. The Employer desires to contract with CMG/CHS and CMG/CHS desires
to contract with the Employer for CMG/CHS to furnish a physician and nurse to provide
certain onsite medical services to the employees of the Employer's health plan and/or
their dependents on the terms and subject to the conditions contained herein.
NOW, THEREFORE, for good and valuable consideration, the receipt and the
sufficiency of which are hereby acknowledged, the Employer and CMG/CHS hereby
agree as follows:
ARTICLE I
SCOPE OF SERVICES
1.01 Provision of Medical Professional. CMG/CHS shall furnish a
physician(s) (hereafter referred as "Medical Professional"), and medical assistants to
include a licensed vocational nurse and a patient representative (hereafter collectively
referred to as "Medical Assistant") to provide the Medical Services (as defined herein) at
a location selected and agreed to by CMG/CHS and provided by the Employer to the
covered employees of the Employer's health plan and/or the dependents thereof.
CMG/CHS is not committing to furnish a particular person as the Medical
Professional/Medical Assistant and, at any time and from time to time, CMG/CHS may
change the Medical Professional/Medical Assistant. Employer shall have the opportunity
to interview all final physician candidates identified by CMG/CHS. Employer shall also
have the right to have CMG/CHS remove a physician upon written notice, which notice
shall specify the time by which the physician shall be removed.
The Medical Services to be furnished by CMG/CHS are listed on Exhibit A.
The Employer and CMG/CHS may, at any time and from time to time, amend or
supplement Exhibit A by written agreement.
1.02 Standards of Medical Professional Performance. CMG/CHS shall ensure
that the Medical Professional is obligated to perform or deliver the following, supported
by a Medical Assistant under the Medical Professional's direction and control:
(a) The Medical Professional shall determine his or her own means and
methods of providing Medical Services in connection with this Agreement.
(b) The Medical Professional shall comply with all applicable laws and
regulations with respect to the licensing and the regulation of physicians, and
shall ensure that the Medical Assistant does the same with respect to the licensing
and regulation of nurses.
(c) The Medical Professional and Medical Assistant shall provide the
Medical Services in a manner consistent with all applicable laws and regulations
and in a professional manner consistent with Medical Services provided in the
community.
(d) The Medical Professional shall maintain, during the term of this
Agreement, Appropriate Credentials including:
(1) A duly issued and active license to practice medicine and
prescribe medication in the State of Texas,
(2) A good standing with his or her profession and State of Texas
professional association,
(3) The absence of any license restriction, revocation, or
suspension,
(4) The absence of any involuntary restriction placed on his or her
federal DEA registration, and
(5) The absence of any conviction of a felony.
(e) In the event that any Medical Professional (1) has his or her license to
practice medicine or prescribe medication restricted, revoked or suspended, (2)
has an involuntary restriction placed on his or her federal DEA registration, (3) is
convicted of a felony, or (4) is no longer in good standing with his or her
professional or State of Texas licensing authority, CMG/CHS shall promptly
remove that Medical Professional and replace such Medical Professional with
another Medical Professional that meets the requirements of Section 1.02 (d).
CMG/CHS shall remove and promptly replace any Medical Assistant or other
Health Professional (as defined in Section 1.08) who has his or her professional
license restricted, revoked or suspended, is convicted of a felony, or is no longer
in good standing with his or her professional or State of Texas licensing authority.
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(f) CMG/CHS shall ensure that any Medical Assistant or other Health
Professional complies with the requirements of this Section 1.02 with respect to
performance, licensing, certification, and good standing, as applicable, except as
otherwise provided in Section 1.06 with respect to medical doctor interns and
residents. CMG/CHS shall require the Medical Professional, Medical Assistant or
any other Health Professional to notify CMG/CHS immediately in the event she
or he learns of the possibility that any of the events specified in Section 1.03(e)
may occur and CMG/CHS shall immediately notify the Employer of such
notification, so that the Employer can determine whether or not to exercise its
right to remove the individual pursuant to Section 1.01.
1.03 Scheduling and Location of Services. CMG/CHS shall mutually agree on
the location(s) and schedule for the provision of the Medical Services.
1.04 Facilities. The Employer shall provide the Medical Professional an
examination room(s) which shall be reasonably satisfactory, in the judgment of the
Medical Professional, for the provision of the Medical Services. In addition, the
Employer shall provide to the Medical Professional a private office, which private office
may be used by the Medical Professional to maintain a desk and a small refrigerator for
the storage of laboratory specimens and prescription drugs; the private office shall be
reasonably satisfactory to the Medical Professional, in the judgment of the Medical
Professional, and the private office shall have a lock which permits the Medical
Professional to limit access to the private office.
1.05 Equipment and Supplies. The Employer shall also provide the equipment
and the supplies listed on Exhibit B. The Medical Professional shall notify the Employer
of additional equipment and supplies reasonably required in connection with the
provision of the Medical Services and the date by which such equipment and supplies are
required and the Employer shall provide such equipment and supplies by that date.
CMG/CHS shall provide the equipment and the supplies listed on Exhibit B.
CMG/CHS shall also work with the Employer's Prescription Benefit Manager to supply
generic and limited brand name prescriptions. The list of such prescriptions may be
changed or updated by Employer. Employer shall notify CMG/CHS of such changes or
updates.
1.06 Insurance. CMG/CHS shall ensure that the Medical Professional
maintains, throughout the term of this Agreement, professional liability insurance
covering the acts and omissions of the Medical Professional, in the minimum annual
coverage amounts and of the type and kind required by the Employer in a type and form
acceptable to the City. In the alternative, if CMG/CHS self -insures as defined under the
Texas Insurance Code, CMG/CHS shall provide to the Employer all state filings
indicating solvency of any self-insured plan and any other proof of solvency as may be
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required by the Employer. CMG/CHS will require the Medical Professional to notify
CMG/CHS immediately in the event he or she does not have the required coverage and
will promptly remove and replace such Medical Professional with another qualified
Medical Professional. CMG/CHS shall provide Employer proof of such professional
liability insurance maintained by the Medical Professional. CMG/CHS will provide a
Certificate of Insurance naming the City of Lubbock as certificate holder. The Certificate
will provide that the insurance company will provide a minimum of ten days prior notice
of cancellation, termination or modification of coverage.
CMG/CHS's shall maintain general liability insurance that shall contain broad form
contractual liability with a combined single limit of a minimum of $1,000,000 each
occurrence and in the aggregate and shall include the following:
• Bodily Injury and Property Damage
• Broad Form Contractual Liability
+ Personal Injury and Advertising Injury
+ Fire legal liability
• Products and completed operations
Medical Professional and CMG/CHS shall elect to obtain workers' compensation
coverage pursuant to Section 406.002 of the Texas Labor Code. Further, Medical
Professional and CMG/CHS shall maintain said coverage throughout the term of this
Agreement and shall comply with all provision of Title 5 of the Texas Labor Code to
ensure that the Medical Professional and CMG/CHS maintains said coverage. Any
termination of workers' compensation insurance coverage by Medical Professional and
CMG/CHS or any cancellation or non -renewal of workers' compensation insurance
coverage for the Medical. Professional and CMG/CHS shall be a material breach of this
contract. Medical Professional and CMG/CHS may maintain Occupational Accident and
Disability Insurance in lieu of Workers' Compensation. In either event, the policy must
be endorsed to include a waiver of subrogation in favor of the City of Lubbock.
Employer's Liability with limits of at least $500,000 each accident, $500,000 by disease
policy limit, and $500,000 by disease each employee shall also be obtained and
maintained throughout the term of this Lease.
CMG/CHS's general liability insurance policy through policy endorsement must
include wording, which states that the policy shall be primary and non-contributory with
respect to any insurance carried by City of Lubbock. The certificate of insurance must
reflect that the above wording is included in evidenced policies. All policies must be
endorsed to include a waiver of subrogation in favor of the City of Lubbock. The
Certificate will provide that the insurance company will provide a minimum of ten days
prior notice of cancellation, termination or modification of coverage.
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1.07 Indemnity and Release. CMG/CHS SHALL INDEMNIFY AND HOLD
HARMLESS, TO THE FULLEST EXTENT PERMITTED BY LAW, THE CITY, AND
CITY'S RESPECTIVE OFFICERS, EMPLOYEES, ELECTED OFFICIALS AND/OR
AGENTS FROM AND AGAINST ANY AND ALL LOSSES, DAMAGES, CLAIMS
OR LIABILITIES, OF ANY FIND OR NATURE, WHICH ARISE DIRECTLY OR
INDIRECTLY, OR ARE RELATED TO, IN ANY WAY, MANNER OR FORM, THE
ACTIVITIES CONTEMPLATED HEREUNDER, CMG/CHS'S OCCUPATION OF
THE LANDS OR OTHER CITY OWNED LANDS, OR THE OMISSION OF THE
ACTIVITIES CONTEMPLATED HEREUNDER CMG/CHS FURTHER COVENANTS
AND AGREES TO DEFEND ANY SUITS OR ADMINISTRATIVE PROCEEDINGS
BROUGHT AGAINST THE CITY AND/OR THE CITY'S RESPECTIVE OFFICERS,
EMPLOYEES, ELECTED OFFICIALS AND/OR AGENTS ON ACCOUNT OF ANY
SUCH CLAIM, AND, WITHOUT LIMITING THE INDEMNITY PROVIDED
HEREIN, TO PAY OR DISCHARGE THE FULL AMOUNT OR OBLIGATION OF
ANY SUCH CLAIM INCURRED BY, ACCRUING TO, OR IMPOSED ON THE
CITY, OR THE CITY'S RESPECTIVE OFFICERS, EMPLOYEES, ELECTED
OFFICIALS AND/OR AGENTS, AS APPLICABLE, RESULTING FROM ANY SUCH
SUITS, CLAIMS, AND/OR ADMIMSTRATIVE PROCEEDINGS OR ANY
MATTERS RESULTING FROM THE SETTLEMENT OR RESOLUTION OF SAID
SUITS, CLAIMS, AND/OR ADMINISTRATIVE PROCEEDINGS.
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THE INDEMNITY AND RELEASE PROVIDED HEREIN SHALL SURVIVE THE
TERMINATION OR VOIDANCE OF THIS AGREEMENT.
1.08 Responsibilities of Parties. The Employer and CMG/CHS are independent
contractors. The CMG/CHS shall be solely responsible for the actions and /or omissions
of Medical Professional, Medical Assistant, and other Health Professionals and the
actions and/or the omissions of any agent or any employee used by CMG/CHS in
connection with providing the Medical Services contemplated by this Agreement.
Neither the Employer nor CMG/CHS shall have any control nor involvement in the
independent exercise of medical judgment by the Medical Professional, and the Employer
shall not incur any liability for the actions or the omissions of the Medical Professional
and/or any agent or any employee used by CMG/CHS in connection with this Agreement.
CMG/CHS agrees to indemnify and hold harmless Employer from and against any cost,
damage, expense, loss, liability or obligation of any kind, including, without limitation,
reasonable attorney's fees, which Employer may incur in connection with CMG/CHS's
furnishing of Medical Professionals, Medical Assistants or other Health Professionals, or
with the medical services provided by them, under this Agreement.
1.09 Other Licensed Health Professionals. The Employer agrees and
acknowledges that CMG/CHS may from time to time have other Health Professionals
assist the Medical Professional and/or replace the Medical Professional during his or her
regularly scheduled time at the Employer's place of business in the event of an
emergency at the hospital or at the Medical Professional's office (provided, however, that
CMG/CHS will require the Medical Professional to ensure that the services provided by
replacement individuals do not exceed the scope of their professional training and
licensure). "Health Professional" shall mean a duly licensed nurse practitioner, medical
doctor and licensed physician's assistant. Sections 1.02 and 1.07 shall apply in the same
manner to the Health Professional as such section applies to the Medical Professional.
CMG/CHS shall also ensure or require that all Health Professionals who provide services
hereunder have insurance coverage consistent with the requirements of Section 1.06.
From time to time CMG/CHS, upon consent of a covered employee of the Employer's
health plan and/or spouse or dependent of the employee, may have medical doctors that
are interns or residents associated with one of the medical schools in the State of Texas
observe and assist the Medical Professional for educational and teaching purposes under
the Medical Professional's direct supervision.
1.10 Billing. CMG/CHS shall ensure that the Medical Professional shall not
solicit payment from covered employees of the Employer's health plan and/or their
dependents, or Employer, or from the Employer Benefit Plan for the Medical Services
provided by the Medical Professional. CMG/CHS may bill, on a zero balance due basis,
the Employer Benefit Plan for the sole purpose of providing information regarding
disease and case management information.
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1.11 Medical Records. CMG/CHS shall maintain medical records with
respect to all of the patients. All medical records shall be maintained in a professional
manner consistent with the accepted practice of the community. CMG/CHS shall also
require the Medical Professional comply with the HIPAA privacy standards. All patient
records maintained by CMG/CHS in connection with this Agreement shall be the sole
property of CMG/CHS subject to the patients' right to access their medical records.
The Employer understands and agrees that all of the medical records and other
protected health information maintained by CMG/CHS will be held in strictest
confidence, and that the Employer will not be entitled to have access to the medical
records maintained by CMG/CHS, in the absence of an appropriate written authorization
from the patient/employee..
CMG/CHS shall be required to have each patient/employee execute a duly
authorized release allowing CMG/CHS to provide medical information to the Employer's
Claim administrator. This is for the sole purpose of providing the Employer's Claim
administrator information necessary for disease and case management.
In the event of termination of this Agreement as outlined in Article 11I,
CMG/CHS will provide to participating covered employees of the Employer's health
plan and/or spouse or dependent of the employee, an appropriate written release form
authorizing the participating covered employee of the Employer's health plan and/or
spouse or dependent of the employee to transfer their medical records to the new on-site
services provider.
1.12 Monthly Reports. CMG/CHS shall provide to the Employer, no later
than the 5ch day of the month immediately following the end of each month of the
calendar year, a written report with respect to the provision of the Medical Services
during the immediately preceding month. The written report shall be in form reasonably
satisfactory to each of the Employer and CMG/CHS and it is contemplated that the
written report will report (a) the number of covered employees and dependents treated by
the Medical Professional during such immediately preceding month, (b) the number of
Health Risk Assessments conducted during such immediately preceding month, and (e)
the number of covered employees for whom primary care services were provided.
1.13 Noncompliance by CMG/CHS. In the event that the Employer becomes
aware of any failure by CMG/CHS to comply with the obligations which are
contemplated by this Agreement, the Employer shall immediately provide written notice
to CMG/CHS of such failure, which written notice shall describe the failure in reasonable
detail, and CMG/CHS shall use its best efforts to address such failure. As provided in
Section 1.41, Employer shall have the right to require the immediate removal of the
Medical Professional by CMG/CHS.
E►m
ARTICLE II
COMPENSATION
2.01 Monthly Fee. No later than the 151h day of each calendar month
immediately following the receipt of the CMG/CHS invoice, the Employer shall pay to
CMG/CHS the amount of $8,333.33 per month, for the months of January through
November, and the amount of $8,333.34 for the Month of December for furnishing the
Medical Services and supplies provided under this Agreement during the immediately
preceding calendar month.
2.02 Additional Fees. No later than the 15th day of each calendar month
immediately following the receipt of the CMG/CHS invoice, the Employer shall pay to
CMG/CHS for additional services as outlined in Exhibit C.
ARTICLE III
TERM AND TERMINATION
3.01 Term. This Agreement shall be for a term of one year commencing on
January 1, 2007, subject to earlier termination in accordance with this Agreement.
Unless either the Employer or CMG/CHS gives written notice of non -renewal to the
other party at least sixty (60) calendar days prior to the end of the initial term or of any
renewal term, this Agreement shall be automatically renewed for an additional two - one
year periods.
3.02 Termination With or Without Cause. This Agreement may be terminated
by either the Employer or CMG/CHS, with or without cause, by providing the other party
at least sixty (60) calendar days' prior written notice.
3,03 Effect of Expiration or Termination. The expiration or the termination of
this Agreement shall not affect the obligation of the Employer to pay compensation to
CMG/CHS or pay for any outstanding invoice for the period prior to such expiration or
termination and shall not affect the obligation of CMG/CHS to provide monthly reports
for the period prior to the effective date of such expiration or such termination.
ARTICLE IV
MISCELLANEOUS
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4.01 Notice. All notices and other communications permitted or required
pursuant to this Agreement shall be in writing, addressed to the party at the address set
forth at the end of this Agreement or to such other address as the party may designate
from time to time in accordance with this Section 4.01. All notices and other
communications shall be (a) mailed by certified or registered mail, return receipt
requested, postage pre -paid, (b) personally delivered or (c) sent by facsimile with a
receipt confirmation. Notices mailed pursuant to this Section 4.01 shall be deemed given
as of three days after the date of mailing and notices personally delivered or sent by
facsimile shall be deemed given at time of receipt.
4.02 Assignment. Except as provided in Section 4.07, neither the Employer
nor CMG/CHS may assign or otherwise transfer this Agreement to a third party without
the prior written consent of the other party, which may be given or withheld by the other
party in its sole discretion.
4.03 Entire Agreement; Amendment. This Agreement constitutes the entire
agreement between the Employer and CMG/CHS with respect to the subject matter
hereof and supersedes all prior agreements. This Agreement shall not be amended or
waived, in whole or in part, except in writing signed by both of the Employer and
CMG/CHS.
4.04 GOVERNING LAW. THIS AGREEMENT IS TO BE CONSTRUED
UNDER TEXAS LAW WITHOUT REGARD TO CONFLICT OF LAW RULES THAT
WOULD DIRECT APPLICATION OF THE LAWS OF ANY OTHER JURISDICTION.
THE OBLIGATIONS OF THE PARTIES CREATED BY THIS AGREEMENT ARE
PERFORMABLE, AT LEAST IN PART, IN LUBBOCK COUNTY, TEXAS. VENUE
FOR ANY ACTION BROUGHT PURSUANT TO THIS AGREEMENT, OR
ACTIVITY CONTEMPLATED HEREBY, SHALL EXCLUSIVELY BE IN LUBBOCK
COUNTY, TEXAS.
4.05 In the conduct of this Agreement, CMG/CHS may use only such
advertising materials as are in compliance with the laws, rules and regulations of the
jurisdictions in which used and which have been approved, in writing by the Employer, in
advance of their use. No written or oral advertising, or marketing material, or letterhead,
business card or other similar matter or material, which includes Employer's name or
otherwise refers to Employer may be printed, published, distributed or used in any way
without the prior written approval thereof by Employer.
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4.05 Access to Books and Records. Subject to applicable privacy laws related
to patient health information, both of CMG/CHS and the Employer agree to provide
access to their books and records, regarding this agreement, to the other party.
4.06 Successors. This Agreement is binding upon the parties, their successors
and assigns. Thirty (30) days notice of any change in ownership, management, etc. shall
be given the other party by the party experiencing the change. In such event, this
Agreement shall be assumed upon a change of ownership, change of control, change in
management, reorganization, etc. of, or at, Employer.
4.07 Compliance. CMG/CHS maintains a Corporate Responsibility Program.
This program is intended to prevent compliance concerns such as fraud, abuse, false
claims, excess private benefit and inappropriate referrals. Employer hereby agrees that
any regulatory compliance concerns that Employer becomes aware of shall be promptly
reported either to an appropriate CMG/CHS manager or through the hotline (877-808-
8133).
CMG/CHS agrees that referrals of employees of the Employer's health plan
and/or their dependents shall be made in accordance with any federal or state laws, and
that CMG/CHS will maintain a copy of the Employer's approved network list at the on-
site clinic for review by patients. This network list shall be used, in consulting with the
patient, to determine the best possible referral.
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IN WITNESS WHEREOF, the Employer and CMG/CHS have executed and
delivered this Agreement as of the date first above written.
CITY OF LUBBOCK, TEXAS
DAVID A. YILLER, MAYOR
ATTEST:
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Rebecca Garza, City Secretary
APPROVED AS TO CONTENT:
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Leisa Hutcheson, Risk Manager
APPROVED AS TO FORM:
Don Vandiver,
Assistant City Attorney
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Resolution No. 2006-RO567
EXHIBIT A
"SCOPE OF SERVICES"
Medical Services include but are not limited to the following:
• Chronic illness evaluation, treatment and management
o Diabetes
o High Cholesterol
o Etc.
• Acute Conditions
o Sore throats/strep/ears/headache
a Cough, Sinus
o Strains/sprains/musculoskeletal problems
o Acute urinary complaints
• Physicals
• Injections and immunizations
• Minor surgical procedures, such as sutures for laceration treatment
• Vaginal and Breast Exams
* Digital Rectal Exams
• ECG
• Urine Pregnancy
• Ordinary and routine care of the nature of a visit to family practice doctor's office
Long Term Prevention Programs Included
• Personal Wellness Profile Risk Assessment with comprehensive blood draw
analysis (not included in base quote, see attached pricing sheet)
• Aggregate data analysis from your employee population that allows us to develop
just the right programs for the Pharmacy Benefit Manager
+ Out reach Program to touch the people with the highest health risks
+ Health Management programs targeted for the greatest impact (obesity, diabetes,
high blood pressure, etc.) via web based education
• Self Care Education Tools and Manual online and in print form
Comprehensive Health Education Training
• Coordination of medical information with Plan Administrator for case and disease
management
Program Enablers and Infrastructure Included
• 24 hour on-call coverage
• Telephonic appointment scheduling
• Medical management and documentation
_!2_
• Clinic Inventory Management (standard supplies)
• Medical Professional recruiting
• Medical Assistant recruiting
• Medical Professional management
• Medical Assistant management
• Monthly Analysis, Trends, Reporting & Survey Results
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Resolution No. 2006-RO567
EXHIBIT B
MEDICAL SUPPLIES AND EQUIPMENT
Items provided by CMG/CHS in accordance with the Agreement.
Disinfectant
Suture supplies
Waste cans
Glucose test supplies
Waste can liners
Strep testing supplies
Gloves
Mono testing supplies
Diag Set 3.5V Halogen/disposable covers
Disposable gowns
Sundry jars
Disposable drapes
Urinalysis supplies
Thermometer (freezer)
Table paper
3" Elastic bandage
Thermometer/disposable covers
Cold pack
4 X 4's
Emesis basins
Tongue depressors
Medications/Injectables (by physician
order)
Cotton balls
Lab supplies (Tubes, requisitions,
tourniquets)
Alcohol
Wall Posters, Charts
Alcohol dispenser
Needles
Blood pressure cuffs
Syringes
Biohazard stickers
Stethoscope
"Allergic To" stickers
Surgical tape
Sharps containers
Biohazard bags and Removal Service
Trash removal, Clean-up, and General
Maintenance
Items provided by the Employer in accordance with the Agreement.
Small refrigerator
Exam stools
Lockable cabinet
Weight/height scales
Gooseneck light
Desk
Waiting room furniture
Chairs
Facility
Utilities
Computer, Fast Internet Connection, "4 in
1" Printer/Fax/Copier/Scanner
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Resolution No. 2006—RO567
EXHIBIT C
ADDITI®NAL SERVICES
Items provided by CMG/CHS in accordance with the Agreement to be paid by Employer.
Basic Lab Tests — the drawing of the blood would be included in the basic additional
services. The following is a list that may from time to time be changed with written
agreement and associated costs:
• Basic Metabolic Panel
$11.00 ea
• Comprehensive Metabolic Panel
$ 9.11 ea
• Lipid Panel
$17.41 ea
• Hepatic Function Panel
$10.62 ea
• Hemoglobin
$12.61 ea
• Iron
$ 8.42 ea
• Prostate Specific Antigent, Total
$23.90 ca
+ Pap Smear (does not include Path prof fees)
$13.73 ea
• Surepath/thinprep
$25.00 ea
• Thyroid Stimulating Hormone
$21.83 ea
• Complete Blood Count
$ 8.41 ea
• Prothrombin Time
$ 5.11 ea
• Sedimentation Rate, Erythrocyte, Non -Automatic
$ 4.61 ea
• Rheumatoid Factor
$ 7.37 ea
• InfAgt, Immunoassay
$15.59 ea
• Bld Ct, HgPlatelet Automated Differential, WBC
$10.00 ea
+ Thyroxine, Free
$11.72 ea
All other lab tests shall be billed to the Employer at the customary rate of the claims
administrator.
Diagnostic tests shall be billed to the Employer's health plan provider.
Health Risk Assessments and associated wellness tests:
• Performed through on-site clinic
• Performed at specific locations/departments
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$35.00 ca
$45.00 ea