HomeMy WebLinkAbout25-46Resolution No. 25-46
RESOLUTION
AUTHORIZING THE EXECUTION OF A PURCHASE OF SERVICE AGREEMENT WITH
EMS MANAGEMENT & CONSULTANTS, INC. FOR EMERGENCY MEDICAL SERVICE
BILLING, COLLECTION AND MANAGEMENT REPORTING
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF ELGIN, ILLINOIS,
that pursuant to Elgin Municipal Code Section 5.02.020B(9) the City Council hereby finds that an
exception to the requirements of the procurement ordinance is necessary and in the best interest of
the city; and
BE IT FURTHER RESOLVED BY THE CITY COUNCIL OF THE CITY OF ELGIN,
ILLINOIS, that Richard G. Kozal, City Manager, and Kimberly A. Dewis, City Clerk, be and are
hereby authorized and directed to execute a Purchase of Service Agreement on behalf of the City
of Elgin with EMS Management & Consultants, Inc., for emergency medical service billing,
collection and management reporting, a copy of which is attached hereto and made a part hereof
by reference.
s/ David J. Kaptain
David J. Kaptain, Mayor
Presented: February 26, 2025
Adopted: February 26, 2025
Vote: Yeas: 9 Nays: 0
Attest:
s/ Kimberly Dewis
Kimberly Dewis, City Clerk
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PURCHASE OF SERVICE AGREEMENT
THIS AGREEMENT is made and entered into this 26th day of February , 2025, by
and between the CITY OF ELGIN, an Illinois municipal corporation (hereinafter referred to as the
"City"), and EMS Management & Consultants, Inc. a North Carolina corporation authorized to do
business in the State of Illinois (hereinafter referred to as the "Service Provider").
WHEREAS, Service Provider is an ambulance billing service company with experience in
providing medical billing and collection services to medical transport providers, including fire and
rescue and emergency medical service (EMS) providers; and
WHEREAS, City is normally engaged in the business of providing emergency medical
services, and billable medical transportation services; and
WHEREAS, City wishes to retain Service Provider to provide medical billing, collection
and related services as set forth in this Agreement.
WHEREAS, the City has determined that it would serve a beneficial public purpose to
enter into an agreement with the Service Provider for the Service Provider to provide certain
contract services as described in this Agreement; and
WHEREAS, the Service Provider represents that it has the necessary expertise and
experience to furnish the Subject Services upon the terms and conditions set forth in this
Agreement; and
WHEREAS, the Service Provider began providing these services in 2024 after merging
with the previous service provider, and that it is in the City's best interests to continue with Service
Provider.
NOW, THEREFORE, in consideration of the mutual promises and covenants contained
herein, the sufficiency of which is hereby mutually acknowledged, the parties hereto hereby agree
as follows:
Scone of Services:
The Service Provider shall provide all of the services pursuant to the terms and conditions
and on the dates and times as described in the document entitled "Scope of Services for 2025
Purchase of Service Agreement", attached hereto and made a part hereof as Exhibit A (such
services, including the terms, conditions, dates and times, are hereinafter referred to as the "Subject
Services"). In the event of any conflict between the provisions of this Agreement and the
provisions of Exhibit A, the provisions of this Agreement shall control. The Service Provider
represents and warrants that the Service Provider has the skills and knowledge necessary to
conduct the Subject Services provided for in Exhibit A and that the Subject Services set forth in
Exhibit A are integral parts of this Agreement and may not be modified, amended or altered, except
by a signed, written amendment to this Agreement, agreed to and executed by both parties hereto.
2. Term of A reement:
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This Agreement shall be effective commencing on March 1, 2025, and shall thereafter
continue through February 29, 2028, ("Initial Term"), unless otherwise terminated as provided
herein. This Agreement may be renewed upon the same terms and conditions as the Initial Term
of this Agreement for up to three successive one-year terms upon the written agreement of the
parties hereto (each a "Renewal Term"). (The Initial Term and any Renewal Terms are referred
to as the "Term"). Notwithstanding anything herein to the contrary, this Agreement may be
terminated under the provisions provided herein.
3. Payment:
a. City shall pay a fee for the Services of Service Provider hereunder, on a monthly
basis, in an amount equal to 3.0% percent of "Net Collections" as defined below (the "RCM
Fee"). The RCM Fee is also sometimes referred to herein as the "Compensation." Net
Collections shall mean all cash and check amounts including electronic fund transfers
(EFTS) received by Service Provider from payers, patients, attorney's offices, court
settlements, collection agencies, government institutions, debt set-off programs, group
health insurance plans, private payments, credit cards, healthcare facilities or any person
or entity submitting funds on a patient's account, or any amounts paid directly to City with
or without the knowledge of Service Provider that are paid, tendered, received or collected
each month for City's transports, less refunds processed or any other necessary adjustments
to those amounts. Net Collections shall not include Ground Emergency Medical
Transportation ("GEMT") money received by City.
b. Service Provider shall submit an invoice in a form approved by the City by the tenth
(10th) day of each month for the Compensation due to Service Provider for the previous
calendar month. The City shall make perioding payments to the Service Provide within
thirty (30) days after receipt and approval of an invoice. Service Provider shall maintain
records showing the basis for the amount of Compensation reflected in an invoice. The
Service Provider shall permit the City to inspect all data and records for the Service
Provider for work done under this Agreement. The Service Provider shall make these
records available at reasonable times during the term of the Agreement and for a period of
one (1) year following the termination of this Agreement.
c. In the event of a material change to applicable law, the billing process and/or scope
of Services provided in this Agreement or a material difference in any of the patient
demographics provided by the City and set forth in Exhibit A, either party reserves the
right to seek to negotiate a fee change with the other parry, and in such circumstances the
parties may amend this Agreement in writing accordingly or terminate this Agreement.
4. Res onsibilities Upon Termination:
a. Upon any termination of this Agreement, and during the period of any notice of
termination, Service Provider will make available to City or its authorized representatives
data from the billing system regarding open accounts in an electronic format, and will
otherwise reasonably cooperate and assist in any transition of the Services to City, or its
successor billing agent. Upon request, Service Provider will provide to City trip data
associated with the claims submitted by Service Provider on behalf of City pursuant to this
Agreement. Service Provider shall retain financial and billing records not tendered or
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returned to City on termination hereof for at least ten (10) years following the date of
service.
b. Following termination of this Agreement, for a period of ninety (90) days (the "Wind
Down"), Service Provider will continue its billing and collection efforts as to those accounts
with dates of services prior to termination, subject to the terms and conditions of this
Agreement including, but not limited to, Section 53 City will continue to provide Service
Provider with copies of checks and payments on those accounts which were filed by Service
Provider under this Agreement. Service Provider shall have no further responsibilities as to
such accounts after the Wind Down; however, Service Provider shall be entitled to
compensation as provided in Section 3.a for such amounts filed by Service Provider,
regardless of whether such amounts are collected by City during or after the Wind Down
period. During the Wind Down and for up to twelve months following termination of this
Agreement, Service Provider shall continue to make the Portals available to City, subject to
the applicable Terms of Use.
5. Exclusivity and Miscellaneous Billing Policies:
a. During the term of this Agreement, Service Provider shall be City's exclusive
provider of the RCM Services. City may not directly file, submit, or invoice for any medical
or medical transportation services rendered while this Agreement is in effect.
b. In addition, City agrees not to collect or accept payment for services from any patient
unless the service requested does not meet coverage requirements under any insurance
program in which the patient is enrolled or the patient is uninsured. Payments received
directly by City for these services must be reported to Service Provider as provided in
Section 3.f of Exhibit A, and shall be treated as Net Collections for purposes of Section 3.a
hereof.
c. In compliance with CMS regulations, Medicare patients will not be charged by City
a higher rate or amount for identical covered services charged to other insurers or patients.
Accordingly, only one fee schedule shall exist and be used in determining charges for all
patients regardless of insurance coverage.
d. Service Provider reserves the right not to submit a claim for reimbursement on any
patient in which the PCR and/or associated medical records are incomplete or appear to be
inaccurate or do not contain enough information to substantiate or justify reimbursement.
This includes missing patient demographic information, insurance information, Physician
Certification Statements (PCS) or any required crew and/or patient signatures, or otherwise
contradictory medical information.
e. City shall implement and maintain a working compliance plan ("Compliance Plan")
in accordance with the most current guidelines of the U.S. Department of Health and
Human Services ("HHS"). The Compliance Plan must include, but not be limited to, formal
written policies and procedures and standards of conduct, designation of a compliance
officer, quality assurance policy and effective training and education programs.
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f. In accordance with the HHS Office of Inspector General ("OIG") Compliance
Program Guidance for Third -Party Medical Billing Companies, Service Provider is
obligated to report misconduct to the government, if Service Provider discovers credible
evidence of City's continued misconduct or flagrant, fraudulent or abusive conduct. In the
event of such evidence, Service Provider has the right to (a) refrain from submitting any
false or inappropriate claims, (b) terminate this Agreement and/or (c) report the misconduct
to the appropriate authorities.
6. Privacy:
a. Confidentiality. The Parties acknowledge that they will each provide to the other
Confidential Information as part of carrying out the terms of this Agreement. Service
Provider and City will be both a Receiving Party and a Disclosing Party at different times.
The Receiving Party agrees that it will not (i) use any such Confidential Information in any
way, except for the exercise of its rights and performance of its obligations under this
Agreement, or (ii) disclose any such Confidential Information to any third party, other than
furnishing such Confidential Information to its employees, consultants, and subcontractors,
who are subject to the safeguards and confidentiality obligations contained in this
Agreement and who require access to the Confidential Information in the performance of
the obligations under this Agreement. In the event that the Receiving Party is required by
applicable law to make any disclosure of any of the Disclosing Parry's Confidential
Information, by subpoena, judicial or administrative order or otherwise, the Receiving
Party will first give written notice of such requirement to the Disclosing Party, and will
permit the Disclosing Party to intervene in any relevant proceedings to protect its interests
in the Confidential Information, and provide full cooperation and assistance to the
Disclosing Party in seeking to obtain such protection, at the Disclosing Party's sole
expense. "Confidential Information" means the provisions of the Agreement (including,
but not limited to, the financial terms herein) and any information disclosed by a Party (the
"Disclosing Party") to the other Party (the "Receiving Party"). Information will not be
deemed Confidential Information hereunder if the Receiving Party can prove by
documentary evidence that such information: (a) was known to the Receiving Party prior
to receipt from the Disclosing Party directly or indirectly from a source other than one
having an obligation of confidentiality to the Disclosing Party; (b) becomes known
(independently of disclosure by the Disclosing Party) to the Receiving Party directly or
indirectly from a source other than one having an obligation of confidentiality to the
Disclosing Party; (c) becomes publicly known or otherwise ceases to be secret or
confidential, except through a breach of this Agreement by the Receiving Party; or (d) is
independently developed by the Receiving Party without the use of any Confidential
Information of the Disclosing Party.
b. HIPAA Compliance. The parties agree to comply with the Business Associate
Addendum, attached hereto and incorporated by reference herein as Exhibit B,
documenting the assurances and other requirements respecting the use and disclosure of
Protected Health Information. It is City's responsibility to ensure that it obtains all
appropriate and necessary authorizations and consents to use or disclose any individually
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identifiable health information in compliance with all federal and state privacy laws, rules
and regulations, including but not limited to the Health Insurance Portability and
Accountability Act. In the event that this Agreement is, or activities permitted or required
by this Agreement are, inconsistent with or do not satisfy the requirements of any
applicable privacy or security law, rule or regulation, the parties shall take any reasonably
necessary action to remedy such inconsistency.
7. Reports:
The Service Provider shall complete, maintain and submit to the City Manager of the
City, or his designee, any and all records, reports, and forms relating to the Subject Services in
this Agreement as requested by the City.
8. No Co -partnership or Agency:
Except as otherwise provide for herein, this Agreement shall not be construed so as to
create a partnership, joint venture, employment, or other agency relationship between the parties
hereto. Service Provider understands and agrees that the relationship of the Service Provider to
the City arising out of this Agreement shall be that of an independent contractor. It is expressly
agreed and understood that the Service Provider and the Service Provider's officers, employees
,and agents are not employees of the City and are not entitled to any benefits or insurance provided
to employees of the City.
9. Breach of Contract
If the Service Provider violates or breaches any term of this Agreement, such violation or
breach shall be deemed to constitute a default, and the City shall have the right to seek
administrative, contractual, legal or equitable remedies as may be suitable to the violation or
breach; and, in addition, if the Service Provider by reason of any default, fails to within fifteen
(15) days after notice thereof by the City to comply with the conditions of the Agreement, the City
may terminate this Agreement. If the City violates or breaches any term of this Agreement, such
violation or breach shall be deemed to constitute a default, and in the event the City fails to within
fifteen (15) days after notice thereof by the Service Provider to comply with the conditions of this
Agreement, the Service Provider as its sole and exclusive remedy may terminate this Agreement.
Notwithstanding anything to the contrary in this Agreement, with the sole exception of the monies
the City has agreed to pay the Service Provider pursuant to Sections 3 and 4 hereof, no action shall
be commenced by the Service Provider, any related persons or entities, and/or any of their
successors and/or assigns, against the City for monetary damages. In the event any legal action is
brought by the City for the enforcement of any of the obligations of the Service Provider in this
Agreement and the City is the prevailing party in such action, the City shall also be entitled to
recover from the Service Provider interest at the rate of nine percent (9%) per annum and
reasonable attorney's fees. Service Provider hereby further waives any and all claims or rights to
interest which it claims it may otherwise be entitled to pursuant to law, including, but not limited
to, the Local Government Prompt Payment Act (50 ILCS 501/1, et seq.), as amended, or the Illinois
Interest Act (815 ILCS 205/1 , et seq.), as amended. The parties hereto further agree that any action
by the Service Provider arising out of this Agreement must be filed within one year of the date the
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alleged cause of action arose or the same will be time barred. The provisions of this section shall
survive any expiration, completion and/or termination of this Agreement.
Notwithstanding any other provision hereof, the City may terminate this Agreement at any time
upon thirty (30) days prior written notice to the Service Provider. In the event this Agreement is
so terminated, the Service Provider shall be paid for services actually performed, and reimbursable
expenses actually incurred prior to termination, except that reimbursement shall not in any event
exceed the total amount set forth under Sections 3 and 4 above.
10. Indemnificaton:
To the fullest extent permitted by law, Service Provider shall indemnify, defend and hold
harmless the City, its officers, employees, agents, boards and commissions from and against any
and all claims, suits, judgments, costs, attorney's fees, damages or other relief, including but not
limited to worker's compensation claims, in any way resulting from or arising out of negligent
actions or omissions of the Service Provider in connection herewith, including negligence or
omissions or agents of the Service Provider arising out of the performance of this Agreement
and/or the Subject Services. In the event of any action against the City, its officers, employees,
agents, boards or commissions covered by the foregoing duty to indemnify, defend and hold
harmless, such action shall be defended by legal counsel of the City's choosing. The provisions of
this section shall survive any expiration, completion and/or termination of this Agreement.
11. No Personal Liability:
No official, director, officer, agent or employee of the City shall be charged personally or
held contractually liable under any term or provision of this Agreement or because of their
execution, approval or attempted execution of this Agreement.
12. Insurance:
The Service Provider shall provide, pay for and maintain in effect, during the term of this
Agreement the following types and amounts of insurance:
a. Comprehensive Liability. A policy of comprehensive general liability insurance
with limits of at least $1,000,000 aggregate for bodily injury and $1,000,000
aggregate for property damage.
The Service Provider shall deliver to the City a Certification of Insurance naming
the City as additional insured. The policy shall not be modified or terminated
without thirty (30) days prior written notice to the City.
The Certificate of Insurance which shall include Contractual obligation assumed by
the Service Provider under Section 10 entitled "Indemnification" shall be provided.
This insurance shall apply as primary insurance with respect to any other insurance
or self-insurance programs afforded to the City. There shall be no endorsement or
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modification of this insurance to make it excess over other available insurance,
alternatively, if the insurance states that it is excess or prorated, it shall be endorsed
to be primary with respect to the City.
All said insurance shall be written by, and secured from, companies approved to do
business and issue insurance in the State of Illinois and must be rated "A-" or better,
in accordance with the latest edition of Best's Insurance Guide, published by AM
Best Company, Inc. or its equivalent.
13. Delegations and Subcontractors:
Any assignment, delegation or subcontracting shall be subject to all of the terms, conditions
and other provisions of this Agreement and the Service Provider shall remain liable to the City
with respect to each and every item, condition and other provision hereof to the same extent that
the Service Provider would have been obligated if it had done the work itself and no assignment,
delegation or subcontract had been made. There shall be no assignment without the City's
advanced written approval which approval may be withheld at the sole discretion of the City.
14. Assienment and Successors:
This Agreement shall be binding on the parties hereto and their respective successors and
permitted assigns. This Agreement and the obligations herein may not be assigned by the Service
Provider without the express written consent of the City which consent may be withheld at the sole
discretion of the City.
15. Nondiscrimination/Affirmative Action
The Service Provider shall not discriminate against any employee or applicant for
employment because of race, color, religion, sex, national origin, age, ancestry, order of protection
status, familial status, marital status, physical or mental disability, military status, sexual
orientation, or unfavorable discharge from military service, unless based upon a bona fide
occupational qualification, and this requirement shall apply to, but not be limited to, the following:
employment, advertising, hiring, layoff or termination, rates of pay or other forms of compensation
and selection for training, including apprenticeship. The Service Provider shall take affirmative
action to comply with the provisions of Elgin Municipal Code Section 5.02.040 and will require
any subcontractor to submit to the City a written commitment to comply with these provisions.
The Service Provider shall distribute copies of this commitment to all persons who will participate
in recruitment, screening, referral and selection job applicants and perspective subcontractors. The
Service Provider agrees that the provisions of Section 5.02.040 of the Elgin Municipal Code, 1976,
as amended, is hereby incorporated by reference, as if said out verbatim.
No person shall be denied or subjected to discrimination in receipt of the benefit of any
services or activities made possible by or resulting from this Agreement on the grounds of race,
color, religion, sex, national origin, age, ancestry, order of protection status, familial status, marital
status, physical or mental disability, military status, sexual orientation, or unfavorable discharge
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from military service. Any violation of this paragraph shall be considered a violation of a material
provision of this Agreement and shall be grounds for cancellation, termination or suspension, in
whole or in part, of the Agreement by the City.
16. SeverabilitY
The terms of this Agreement shall be severable. In the event any of the terms or provisions
of this Agreement are deemed to be void or otherwise unenforceable for any reason, the remainder
of this Agreement shall remain in full force and effect.
17. Entire Aereeement:
This Agreement and its exhibits constitute the entire Agreement of the parties on the subject matter
hereof and may not be changed, modified, discharged or extended except by written amendment
duly executed by the parties. Each parry agrees that no representations or warranties shall be
binding upon the other party unless expressed in writing herein or in a duly executed amendment
hereof.
18. Applicable Law:
This Agreement shall be deemed to have been made in, and shall be construed in
accordance with the laws of the State of Illinois. Venue for the resolution of any disputes or the
enforcement of any rights pursuant to this Agreement shall be in the Circuit Court of Kane County,
Illinois.
19. Interference with Public Contracting
The Service Provider certifies hereby that it is not barred from bidding on a public contact
as a result of a violation of 720 ILCS 5/33E et seq. or any similar state or federal statute regarding
bid rigging.
20. Sexual Harassment:
As a condition precedent of this contract, the Service Provider shall have written sexual
harassment policies that include, at a minimum, the following information:
a. the illegality of sexual harassment;
b. the definition of sexual harassment under state law;
a description of sexual harassment, utilizing examples;
d. the vendor's internal complaint process including penalties;
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e. the legal recourse, investigative and complaint process available
through the Illinois Department of Human Rights, and the Illinois
Human Rights Commission;
f. directions on how to contact the department and commission; and
g. protection against retaliation as provided by Section 6-101 of the
Human Rights Act.
A copy of the policies shall be provided by the Service Provider to the Department
of Human Rights upon request (775 ILCS 5/2-105).
21. Substance Abuse Pro -,ram:
As a condition precedent of this Agreement, the Service Provider shall have in place a
written substance abuse prevention program which meets or exceeds the program requirements in
the Substance Abuse Prevention Public Works Act at 820 ILCS 265/1, et seq. A copy of such
policy shall be provided to the City's Assistant City Manager prior to the entry and execution of
this Agreement.
22. Appropriations:
The fiscal year of the City is the 12 month period ending December 31. The obligations
of the City under any agreement for any fiscal year are subject to and contingent upon the
appropriation of funds sufficient to discharge the obligations which accrue in that fiscal year and
authorization to spend such funds for the purpose of the Agreement.
If, for any fiscal year the term of the Agreement, sufficient funds for the discharge of the
City's obligations under the Agreement are not appropriated and authorized, then the Agreement
shall terminate as of the last day of the preceding fiscal year, or when such appropriated and
authorized funds are exhausted, whichever is later, without liability to the City for damages,
penalties or other charges on account of such termination.
23. Compliance With Laws:
Notwithstanding any other provision in this Agreement, it is expressly agreed and
understood that in connection with the performance of this Agreement the Service Provider shall
comply with all applicable federal, state, city and other requirements of law including, but not
limited to, any applicable requirements regarding prevailing wages, minimum wage, workplace
safety and legal status of employees. Without limiting the foregoing, the Service Provider hereby
certifies, represents and warrants to the City that all of Service Provider's employees and/or agents
who will be providing products, and/or services with respect to this Agreement shall be legally
authorized to work in the United States. Service Provider shall also, at its expense, secure all
permits and licenses, pay all charges and fees and give all notices necessary and incident to the
due and lawful prosecution of the work, and/or the products and/or services to be provided pursuant
to this Agreement. City shall have the right to audit any records in the possession or control of the
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Service Provider to determine the Service Provider's compliance with the provisions of this
section. In the event the City proceeds with such an audit, the Service Provider shall make
available to the City the City's relevant records at no cost to the City. Service Provider shall pay
any and all costs associated with any such audit. The provisions of this section shall survive any
expiration, completion and/or termination of this Agreement.
24. Notices:
All notices, reports and documents required under this Agreement shall be in writing and
shall be mailed by First Class Mail, postage prepaid, addressed as follows:
As to the City:
City of Elgin
150 Dexter Court
Elgin, IL 60120-5555
Attention: City Manager
With a copy to:
City of Elgin
150 Dexter Court
Elgin, IL 60120-5555
Attention: Corporation Counsel
As to Service Provider:
EMS Management & Consultants, Inc.
Chief Executive Officer
2540 Empire Drive, Suite 100
Winston-Salem, NC 27103
25. Joint and Collective Work Product:
This Agreement is and shall be deemed and construed to be a joint and collective work
product of the City and the Service Provider and, as such, this Agreement shall not be construed
against the other party, as the otherwise purported drafter of same, by any court of competent
jurisdiction in order to resolve any inconsistency, ambiguity, vagueness or conflict, if any,, of the
terms and provisions contained herein.
26. Counterparts and Execution:
This Agreement may be executed in counterparts, each of which shall be an original and
all of which shall constitute one and the same agreement. This Agreement may be executed
electronically, and any signed copy of this Agreement transmitted by facsimile machine, email, or
other electronic means shall be treated in all manners and respects as an original document. The
signature of any party on a copy of this Agreement transmitted by facsimile machine, email, or
other electronic means shall be considered for these purposes an original signature and shall have
the same legal effect as an original signature.
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IN WITNESS WHEREOF, the undersigned have entered into executed this Agreement on
the date and year first written above.
CITY OF EL N: EMS 'K/f— .r.-.-* 2. Consultants, Inc.
Signed by:
By: -Ea. `-'7uV't'
D B54ABACD10486
By: Name/print: jay Gyure
City Manager
At st
71
City Clerk
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Title: chief Financial officer
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EXHIBIT A
SCOPE OF SERVICES
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EXHIBIT B
BUSINESS ASSOCIATE AGREEMENT
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1Z
Exhibit A
Scope of Services for 2025 Purchase of Service Agreement
1. ENGAGEMENT.
a. During the term of this Agreement, SERVICE PROVIDER shall provide routine
billing, bill processing and fee collection services reasonably required and customary for service
providers of similar size and situation to City (the "Revenue Cycle Management Services" or
"RCM Services"). The RCM Services shall include: (1) preparing and submitting initial and
secondary claims and bills for City to insurers and others responsible for payment; (2) performing
reasonable and diligent routine collection efforts to secure payments from primary and secondary
payers and patients or other entities, (as SERVICE PROVIDER in its sole discretion deems
appropriate); (3) issuing up to three patient statements for all unpaid balances; and (4) referring
accounts which have not been collected during SERVICE PROVIDER normal billing cycle to an
outside collection agency if so directed by City.
b. Collectively, the RCM Services that SERVICE PROVIDER provides to City shall
be referred to as the "Services".
2. SERVICE PROVIDER Responsibilities.
a. SERVICE PROVIDER will provide the RCM Services in material compliance with
all applicable state and federal laws and regulations.
b. SERVICE PROVIDER will submit all "Completed Claims" to the applicable third -
party payer. A "Completed Claim" is a claim for emergency medical services and billable medical
transportation services that (i) is received by SERVICE PROVIDER and supported by an ePCR
record that contains all necessary and accurate information; (ii) has been reviewed and any
identified issues sent to City for remediation have been rectified; (iii) is for a patient encounter that
has been electronically signed off by City in the ePCR; (iv) has been reviewed by City and deemed
ready for billing; and (v) is not subject to a billing hold. SERVICE PROVIDER will not have any
responsibility for any adverse impact to City that may result from any delay of City in completing
claims.
c. Accounts with outstanding balances after the insurance and/or third -parry payer has
determined benefits due will be billed by SERVICE PROVIDER to the patient. SERVICE
PROVIDER will send up to three patient statements to the patient or responsible party, except as
to those accounts on which an insurance carrier or third -party payer has accepted responsibility to
pay. Once City has submitted all necessary information, SERVICE PROVIDER will bill all
uninsured patients directly.
d. Within ten (10) business days of the last business day of the month, SERVICE
PROVIDER will provide to City a month end report, which shall include an account analysis
report, aging report and accounts receivables reconciliation report for the previous month. Deposit
reports will be provided daily.
e. During the term of this Agreement, SERVICE PROVIDER shall maintain, provide
appropriate storage and data back-up for all billing records pertaining to the RCM Services
provided by SERVICE PROVIDER hereunder. Upon at least five (5) business days' prior written
notice, SERVICE PROVIDER shall make such records accessible to City during SERVICE
PROVIDER business hours. Upon termination of this Agreement, trip data pertaining to the RCM
Services shall be returned to City. Notwithstanding anything to the contrary herein, City
acknowledges and agrees that SERVICE PROVIDER is not a custodian of clinical records nor a
clinical records repository. City is responsible for maintaining all clinical records in accordance
with Section 3(d).
f. SERVICE PROVIDER shall notify City of (i) all patient complaints about clinical
services within five (5) business days of receipt; (ii) all patient complaints about billing within ten
(10) business days of receipt; and (iii) all notices of audit, requests for medical records or other
contacts or inquiries out of the normal course of business from representatives of Medicare,
Medicaid or private payers with which City contracts or any law enforcement or government
agency ("Payer Inquiries") within ten (10) business days of receipt, unless such agency prohibits
SERVICE PROVIDER from disclosing its inquiry to City.
g. SERVICE PROVIDER is appointed as the agent of City under this Agreement
solely for the express purposes of this Agreement relating to billing and receiving payments and
mail, receiving and storing documents, and communicating with hospitals and other entities to
facilitate its duties. SERVICE PROVIDER will have no authority to pledge credit, contract, or
otherwise act on behalf of City except as expressly set forth herein.
h. As to all payments received from Medicare, Medicaid and other government funded
programs, the parties specifically acknowledge that SERVICE PROVIDER will only prepare
claims for City and will not negotiate checks payable or divert electronic fund transfers to City
from Medicare, Medicaid or any other government funded program. All Medicare, Medicaid and
any other government funded program payments, including all electronic fund transfers, will be
deposited directly into a bank account designated by City to receive such payments and as to such
account only City, through its officers and directors, shall have access.
The Services provided by SERVICE PROVIDER to City under this Agreement are
conditioned on City's fulfillment of the responsibilities set forth in Attachment A.
Fn
services:
j. SERVICE PROVIDER shall have no responsibility to provide any of the following
i. Determining the accuracy or truthfulness of documentation and information
provided by City;
ii. Providing services outside the SERVICE PROVIDER billing system;
iii. Submitting any claim that SERVICE PROVIDER believes to be inaccurate or
fraudulent; or
iv. Providing any service not expressly required of SERVICE PROVIDER by this
Agreement.
k. For City's service dates that occurred prior to the mutually agreed go live date for
the Services, City agrees and understands that SERVICE PROVIDER is not responsible for any
services including, but not limited to, submitting claims or managing any denials, refunds or
patient calls. As between City and SERVICE PROVIDER, City is fully responsible for the proper
billing and accounting of any remaining balances related to service dates that occurred prior to
such go live date.
3. RESPONSIBILITIES OF CITY. The following responsibilities of City are a
condition of services under this Agreement, and SERVICE PROVIDER shall have no obligation
to provide the Services to the extent that City has not fulfilled these responsibilities:
a. City will pay all amounts owed to SERVICE PROVIDER under this Agreement.
b. City will implement standard commercially reasonable actions and processes as
may be requested by SERVICE PROVIDER from time -to -time to allow SERVICE PROVIDER
to properly and efficiently provide the RCM Services. These actions and processes include, but
are not limited to, the following:
i. Providing SERVICE PROVIDER with complete and accurate demographic and
charge information necessary for the processing of professional and/or
technical component billing to third parties and/or patients including, without
limitation, the following: patient identification (name, address, phone number,
birth date, gender); guarantor identification and address; report of services;
special claim forms; pre -authorization numbers; and such additional
information as is requested by SERVICE PROVIDER;
ii. Providing SERVICE PROVIDER with complete and accurate demographic and
charge information necessary for the processing of professional and/or
technical component billing to third parties and/or patients including, without
limitation, the following: patient identification (name, address, phone number,
m
birth date, gender); guarantor identification and address; report of services;
special claim forms; pre -authorization numbers; and such additional
information as is requested by SERVICE PROVIDER;
iii. Providing SERVICE PROVIDER with complete and accurate medical record
documentation for each incident or patient service rendered for reimbursement,
which is necessary to ensure proper billing and secure claim payment;
iv. Providing SERVICE PROVIDER, in a timely manner, with Patient Care
Reports (PCRs) that thoroughly detail the patient's full medical condition at the
time of service and include a chronological narrative of all services and
treatment rendered;
V. Obtaining authorizations and signatures on all required forms, including
consent to treat, assignment of benefits, release of information and claims;
vi. Obtaining physician certification statements (PCS) forms for all non -
emergency transports and other similar medical necessity forms or prior
authorization statements as deemed necessary by the payer;
vii. Obtaining or executing all forms or documentation required by Medicare,
Medicaid, CHAMPUS, and any other payer or insurance carriers to allow
SERVICE PROVIDER to carry out its billing and other duties under this
Agreement; and
viii. Implementing reasonable and customary charges for complete, compliant
billing.
c. City represents and warrants that the PCR and any and all associated medical
records, forms and certification statements provided to SERVICE PROVIDER are true and
accurate and contain only factual information observed and documented by the attending field
technician during the course of the treatment and transport.
d. City shall maintain City's own files with all original or source documents, as
required by law, and only provide to SERVICE PROVIDER copies of such documents. City
acknowledges that SERVICE PROVIDER is not the agent of City for storage of source
documentation.
e. City will provide SERVICE PROVIDER with a copy of any existing billing policy
manuals or guidelines, Medicare or Medicaid reports, or any other record or document related to
services or billing of City's accounts.
f. City will report to SERVICE PROVIDER within ten (10) business days of
payments received directly by City, and promptly notify SERVICE PROVIDER of any cases
requiring special handling or billing. City shall advise SERVICE PROVIDER of any Payer
Inquiries within ten (10) business days of receipt.
g. City shall ensure that any refunds posted by SERVICE PROVIDER are actually
issued and paid to the patient, insurer, or other payer as appropriate.
h. City agrees to provide SERVICE PROVIDER with administrative access to the
ePCR system or similar access in order to run reports and review documents and attachments to
better service City's account.
i. City shall provide SERVICE PROVIDER with access to its facilities and personnel
for the purpose of providing on -site and/or online training to such personnel. City shall cooperate
with SERVICE PROVIDER and facilitate any training that SERVICE PROVIDER wishes to
provide.
j. City shall comply with all applicable federal, state, and local laws, rules,
regulations, and other legal requirements that in any way affect this Agreement or the duties and
responsibilities of the parties hereunder.
4. SERVICE PROVIDER WEB PORTALS.
a. SERVICE PROVIDER shall provide City and those individuals appointed by City
("Users") with access to SERVICE PROVIDER Web Portals (the "Portals"), which shall be
subject to the applicable Terns of Use found on the Portals. To be appointed as a User, the
individual must be an employee of City or otherwise approved by City and SERVICE PROVIDER.
City is responsible for all activity of Users and others accessing or using the Portals through or on
behalf of City including, but not limited to, ensuring that Users do not share credentials for
accessing the Portals. City is also responsible for (i) identifying individuals who City determines
should be Users; (ii) determining and notifying SERVICE PROVIDER of each User's rights; (iii)
monitoring Users' access to and use of the Portals; (iv) acting upon any suspected or unauthorized
access of information through the Portals; (v) ensuring each User's compliance with this
Agreement and the Terms of Use governing the use of the Portals; and (vi) notifying SERVICE
PROVIDER to deactivate a User account whenever a User's employment, contract or affiliation
with City is terminated or City otherwise desires to suspend or curtail a User's access to and use
of the Portals. City agrees to follow best practices to ensure compliance with this provision.
b. City acknowledges that SERVICE PROVIDER may suspend or terminate any
User's access to the Portals (i) for noncompliance with this Agreement or the applicable Terms of
Use; (ii) if such User poses a threat to the security or integrity of the Portals or information
available therein; (iii) upon termination of City; or (iv) upon notice of suspension or termination
of such User by City. City may suspend or terminate a User's access to the Portals at any time.
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Attachment B
Business Associate Addendum
This Business Associate Addendum (the "Addendum") is made effective the 13th day of February
2025, by and between the City of Elgin, hereinafter referred to as "Covered Entity," and EMS Management
& Consultants, Inc., hereinafter referred to as "Business Associate" (individually, a "Party" and
collectively, the "Parties").
WITNESSETH:
WHEREAS, the Parties wish to enter into a Business Associate Addendum to ensure compliance
with the Privacy and Security Rules of the Health Insurance Portability and Accountability Act of 1996
("HIPAA Privacy and Security Rules") (45 C.F.R. Parts 160 and 164); and
WHEREAS, the Health Information Technology for Economic and Clinical Health ("HITECH")
Act of the American Recovery and Reinvestment Act of 2009, Pub. L. 111-5, modified the HIPAA Privacy
and Security Rules (hereinafter, all references to the "HIPAA Privacy and Security Rules" include all
amendments thereto set forth in the HITECH Act and any accompanying regulations); and
WHEREAS, the Parties have entered into a Billing Services Agreement (the "Agreement")
whereby Business Associate will provide certain services to Covered Entity and, pursuant to such
Agreement, Business Associate may be considered a "business associate" of Covered Entity as defined in
the HIPAA Privacy and Security Rules; and
WHEREAS, Business Associate may have access to Protected Health Information or Electronic
Protected Health Information (as defined below) in fulfilling its responsibilities under the Agreement; and
WHEREAS, Covered Entity wishes to comply with the HIPAA Privacy and Security Rules, and
Business Associate wishes to honor its obligations as a Business Associate to Covered Entity.
THEREFORE, in consideration of the Parties' continuing obligations under the Agreement, and for other
good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties
agree to the provisions of this Addendum.
I. DEFINITIONS
Except as otherwise defined herein, any and all capitalized terms in this Addendum shall have the
definitions set forth in the HIPAA Privacy and Security Rules. In the event of an inconsistency between the
provisions of this Addendum and mandatory provisions of the HIPAA Privacy and Security Rules, as
amended, the HIPAA Privacy and Security Rules in effect at the time shall control. Where provisions of
this Addendum are different than those mandated by the HIPAA Privacy and Security Rules, but are
nonetheless permitted by the HIPAA Privacy and Security Rules, the provisions of this Addendum shall
control.
The term "Breach" means the unauthorized acquisition, access, use, or disclosure of protected health
information which compromises the security or privacy of such information, except where an unauthorized
person to whom such information is disclosed would not reasonably have been able to retain such
information. The term "Breach" does not include: (1) any unintentional acquisition, access, or use of
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protected health information by any employee or individual acting under the authority of a covered entity
or business associate if (a) such acquisition, access, or use was made in good faith and within the course
and scope of the employment or other professional relationship of such employee or individual,
respectively, with the covered entity or business associate, and (b) such information is not further acquired,
accessed, used, or disclosed by any person; or (2) any inadvertent disclosure from an individual who is
otherwise authorized to access protected health information at a facility operated by a covered entity or
business associate to another similarly situated individual at same facility; and (3) any such information
received as a result of such disclosure is not further acquired, accessed, used, or disclosed without
authorization by any person.
The term "Electronic Health Record" means an electronic record of health -related information on an
individual that is created, gathered, managed, and consulted by authorized health care clinicians and staff.
The term "HIPAA Privacy and Security Rules" refers to 45 C.F.R. Parts 160 and 164 as currently in effect
or hereafter amended.
The term "Protected Health Information" means individually identifiable health information as defined in
45 C.F.R § 160.103, limited to the information Business Associate receives from, or creates, maintains,
transmits, or receives on behalf of, Covered Entity.
The term `Electronic Protected Health Information" means Protected Health Information which is
transmitted by or maintained in Electronic Media (as now or hereafter defined in the HIPAA Privacy and
Security Rules).
The term "Secretary" means the Secretary of the Department of Health and Human Services.
The term "Unsecured Protected Health Information" means Protected Health Information that is not
rendered unusable, unreadable, or indecipherable to unauthorized individuals through the use of a
technology or methodology specified by the Secretary in guidance published in the Federal Register at 74
Fed. Reg. 19006 on April 27, 2009 and in annual guidance published thereafter.
11. PERMITTED USES AND DISCLOSURES BY BUSINESS ASSOCIATE
a. Business Associate may use or disclose Protected Health Information to perform functions,
activities, or services for, or on behalf of, Covered Entity as specified in the Agreement or this Addendum,
provided that such use or disclosure would not violate the HIPAA Privacy and Security Rules if done by
Covered Entity. Until such time as the Secretary issues regulations pursuant to the HITECH Act specifying
what constitutes "minimum necessary" for purposes of the HIPAA Privacy and Security Rules, Business
Associate shall, to the extent practicable, disclose only Protected Health Information that is contained in a
limited data set (as defined in Section 164.514(e)(2) of the HIPAA Privacy and Security Rules), unless the
person or entity to whom Business Associate is making the disclosure requires certain direct identifiers in
order to accomplish the intended purpose of the disclosure, in which event Business Associate may disclose
only the minimum necessary amount of Protected Health Information to accomplish the intended purpose
of the disclosure.
b. Business Associate may use Protected Health Information in its possession for its proper
management and administration and to fulfill any present or future legal responsibilities of Business
Associate, provided that such uses are permitted under state and federal confidentiality laws.
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c. Business Associate may disclose Protected Health Information in its possession to third parties
for the purposes of its proper management and administration or to fulfill any present or future legal
responsibilities of Business Associate, provided that:
1. the disclosures are required by law; or
2. Business Associate obtains reasonable assurances from the third parties to whom the
Protected Health Information is disclosed that the information will remain confidential and be used or
further disclosed only as required by law or for the purpose for which it was disclosed to the third party,
and that such third parties will notify Business Associate of any instances of which they are aware in which
the confidentiality of the information has been breached.
d. Until such time as the Secretary issues regulations pursuant to the HITECH Act specifying what
constitutes "minimum necessary" for purposes of the HIPAA Privacy and Security Rules, Business
Associate shall, to the extent practicable, access, use, and request only Protected Health Information that is
contained in a limited data set (as defined in Section 164.514(e)(2) of the HIPAA Privacy and Security
Rules), unless Business Associate requires certain direct identifiers in order to accomplish the intended
purpose of the access, use, or request, in which event Business Associate may access, use, or request only
the minimum necessary amount of Protected Health Information to accomplish the intended purpose of the
access, use, or request. Covered Entity shall determine what quantum of information constitutes the
"minimum necessary" amount for Business Associate to accomplish its intended purposes.
e. Business Associate may use Protected Health Information to de -identify such information in
accordance with 45 C.F.R. § 164.514(b) for Business Associate's own business purposes or in connection
with the services provided pursuant to the Agreement or to provide Data Aggregation services to Customer
as permitted by 45 C.F.R. 164.504(e)(2)(i)(b). Once the Protected Health Information has been de -
identified or aggregated, it is no longer considered Protected Health Information governed by this
Addendum.
III. OBLIGATIONS AND ACTIVITIES OF BUSINESS ASSOCIATE
a. Business Associate acknowledges and agrees that all Protected Health Information that is created
or received by Covered Entity and disclosed or made available in any form, including paper record, oral
communication, audio recording, and electronic display by Covered Entity or its operating units to Business
Associate or is created or received by Business Associate on Covered Entity's behalf shall be subject to this
Addendum.
b. Business Associate agrees to not use or further disclose Protected Health Information other than
as permitted or required by the Agreement, this Addendum or as required by law.
c. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of Protected
Health Information other than as provided for by this Addendum. Specifically, Business Associate will:
1. implement the administrative, physical, and technical safeguards set forth in Sections
164.308, 164.310, and 164.312 of the HIPAA Privacy and Security Rules that reasonably and appropriately
protect the confidentiality, integrity, and availability of any Protected Health Information that it creates,
receives, maintains, or transmits on behalf of Covered Entity, and, in accordance with Section 164.316 of
the HIPAA Privacy and Security Rules, implement and maintain reasonable and appropriate policies and
procedures to enable it to comply with the requirements outlined in Sections 164.308, 164.310, and
164.312; and
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2. report to Covered Entity any use or disclosure of Protected Health Information not
provided for by this Addendum of which Business Associate becomes aware. Business Associate shall
report to Covered Entity any Security Incident of which it becomes aware. Notice is deemed to have been
given for unsuccessful Security Incidents, such as (i) "pings" on an information system firewall; (ii) port
scans; (iii) attempts to log on to an information system or enter a database with an invalid password or user
name; (iv) denial -of -service attacks that do not result in a server being taken offline; or (v) malware (e.g.,
a worms or a virus) that does not result in unauthorized access, use, disclosure, modification or destruction
of Protected Health Information.
d. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business Associate on
behalf of Covered Entity, agrees to the same restrictions and conditions that apply through this Addendum
to Business Associate with respect to such information.
e. Business Associate agrees to comply with any requests for restrictions on certain disclosures of
Protected Health Information to which Covered Entity has agreed in accordance with Section 164.522 of
the HIPAA Privacy and Security Rules and of which Business Associate has been notified by Covered
Entity. In addition, and notwithstanding the provisions of Section 164.522 (a)(1)(ii), Business Associate
agrees to comply with an individual's request to restrict disclosure of Protected Health Information to a
health plan for purposes of carrying out payment or health care operations if the Protected Health
Information pertains solely to a health care item or service for which Covered Entity has been paid by in
full by the individual or the individual's representative.
£ At the request of the Covered Entity and in a reasonable time and manner, not to extend ten (10)
business days, Business Associate agrees to make available Protected Health Information required for
Covered Entity to respond to an individual's request for access to his or her Protected Health Information
in accordance with Section 164.524 of the HIPAA Privacy and Security Rules. If Business Associate
maintains Protected Health Information electronically, it agrees to make such Protected Health Information
available electronically to the applicable individual or to a person or entity specifically designated by such
individual, upon such individual's request.
g. At the request of Covered Entity and in a reasonable time and manner, Business Associate agrees
to make available Protected Health Information required for amendment by Covered Entity in accordance
with the requirements of Section 164.526 of the HIPAA Privacy and Security Rules.
h. Business Associate agrees to document any disclosures of and make Protected Health
Information available for purposes of accounting of disclosures, as required by Section 164.528 of the
HIPAA Privacy and Security Rules.
i. Business Associate agrees that it will make its internal practices, books, and records relating to
the use and disclosure of Protected Health Information received from, or created or received by Business
Associate on behalf of, Covered Entity, available to the Secretary for the purpose of determining Covered
Entity's compliance with the HIPAA Privacy and Security Rules, in a time and manner designated by the
Secretary, subject to attorney -client and other applicable privileges.
j. Business Associate agrees that, while present at any Covered Entity facility and/or when
accessing Covered Entity's computer network(s), it and all of its employees, agents, representatives and
subcontractors will at all times comply with any network access and other security practices, procedures
and/or policies established by Covered Entity including, without limitation, those established pursuant to
the HIPAA Privacy and Security Rules.
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k. Business Associate agrees that it will not directly or indirectly receive remuneration in exchange
for any Protected Health Information of an individual without the written authorization of the individual or
the individual's representative, except where the purpose of the exchange is:
1. for public health activities as described in Section 164.512(b) of the Privacy and Security
Rules;
2. for research as described in Sections 164.501 and 164.512(i) of the Privacy and Security
Rules, and the price charged reflects the costs of preparation and transmittal of the data for such purpose;
3. for treatment of the individual, subject to any further regulation promulgated by the
Secretary to prevent inappropriate access, use, or disclosure of Protected Health Information;
4. for the sale, transfer, merger, or consolidation of all or part of Business Associate and
due diligence related to that activity;
5. for an activity that Business Associate undertakes on behalf of and at the specific request
of Covered Entity;
6. to provide an individual with a copy of the individual's Protected Health Information
pursuant to Section 164.524 of the Privacy and Security Rules; or
7. other exchanges that the Secretary determines in regulations to be similarly necessary
and appropriate as those described in this Section III.k.
1. Business Associate agrees to implement a reasonable system for discovery of breaches and
method of risk analysis of breaches to meet the requirements of HIPAA, The HITECH Act, and the HIPAA
Regulations, and shall be solely responsible for the methodology, policies, and procedures implemented by
Business Associate.
in. State Privacy Laws. Business Associate shall understand and comply with state privacy laws to
the extent that state privacy laws are not preempted by HIPAA or The HITECH Act.
IV. BUSINESS ASSOCIATE'S MITIGATION AND BREACH NOTIFICATION
OBLIGATIONS
a. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known
to Business Associate of a use or disclosure of Protected Health Information by Business Associate in
violation of the requirements of this Addendum.
b. Following the discovery of a Breach of Unsecured Protected Health Information, Business
Associate shall notify Covered Entity of such Breach without unreasonable delay and in no case later than
forty-five (45) calendar days after discovery of the Breach. A Breach shall be treated as discovered by
Business Associate as of the first day on which such Breach is known to Business Associate or, through the
exercise of reasonable diligence, would have been known to Business Associate.
c. Notwithstanding the provisions of Section IV.b., above, if a law enforcement official states to
Business Associate that notification of a Breach would impede a criminal investigation or cause damage to
national security, then:
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1. if the statement is in writing and specifies the time for which a delay is required, Business
Associate shall delay such notification for the time period specified by the official; or
2. if the statement is made orally, Business Associate shall document the statement,
including the identity of the official making it, and delay such notification for no longer than thirty (30)
days from the date of the oral statement unless the official submits a written statement during that time.
Following the period of time specified by the official, Business Associate shall promptly deliver a copy of
the official's statement to Covered Entity.
d. The Breach notification provided shall include, to the extent possible:
1. the identification of each individual whose Unsecured Protected Health Information has
been, or is reasonably believed by Business Associate to have been, accessed, acquired, used, or disclosed
during the Breach;
2. a brief description of what happened, including the date of the Breach and the date of
discovery of the Breach, if known;
3. a description of the types of Unsecured Protected Health Information that were involved
in the Breach, if known (such as whether full name, social security number, date of birth, home
address, account number, diagnosis, disability code, or other types of information were involved);
4. any steps individuals should take to protect themselves from potential harm resulting
from the Breach; and
5. a brief description of what Business Associate is doing to investigate the Breach, to
mitigate harm to individuals, and to protect against any further Breaches.
e. Business Associate shall provide the information specified in Section IVA., above, to Covered
Entity at the time of the Breach notification if possible or promptly thereafter as information becomes
available. Business Associate shall not delay notification to Covered Entity that a Breach has occurred in
order to collect the information described in Section IVA. and shall provide such information to Covered
Entity even if the information becomes available after the forty-five (45)-day period provided for initial
Breach notification.
V. OBLIGATIONS OF COVERED ENTITY
a. Upon request of Business Associate, Covered Entity shall provide Business Associate with the
notice of privacy practices that Covered Entity produces in accordance with Section 164.520 of the HIPAA
Privacy and Security Rules.
b. Covered Entity shall provide Business Associate with any changes in, or revocation of,
permission by an individual to use or disclose Protected Health Information, if such changes affect Business
Associate's permitted or required uses and disclosures.
c. Covered Entity shall notify Business Associate of any restriction to the use or disclosure of
Protected Health Information to which Covered Entity has agreed in accordance with Section 164.522 of
the HIPAA Privacy and Security Rules, and Covered Entity shall inform Business Associate of the
termination of any such restriction, and the effect that such termination shall have, if any, upon Business
Associate's use and disclosure of such Protected Health Information.
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VI. TERM AND TERMINATION
a. Term. The Term of this Addendum shall be effective as of the date first written above, and shall
terminate upon the later of the following events: (i) in accordance with Section VII.c., when all of the
Protected Health Information provided by Covered Entity to Business Associate or created or received by
Business Associate on behalf of Covered Entity is destroyed or returned to Covered Entity or, if such return
or destruction is infeasible, when protections are extended to such information; or (ii) upon the expiration
or termination of the Agreement.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach of this
Addendum by Business Associate and Business Associate's failure to cure such breach within thirty (30)
days of receiving notice of same from Covered Entity, Covered Entity shall have the right to terminate this
Addendum and the Agreement.
c. Effect of Termination.
1. Except as provided in paragraph 2. of this subsection, upon termination of this
Addendum, the Agreement or upon request of Covered Entity, whichever occurs first, Business Associate
shall return or destroy all Protected Health Information received from Covered Entity, or created or received
by Business Associate on behalf of Covered Entity. This provision shall apply to Protected Health
Information that is in the possession of subcontractors or agents of Business Associate. Neither Business
Associate nor its subcontractors or agents shall retain copies of the Protected Health Information.
2. In the event that Business Associate determines that returning or destroying the Protected
Health Information is infeasible, Business Associate shall provide to Covered Entity notification of the
conditions that make return or destruction infeasible and shall extend the protections of this Addendum to
such Protected Health Information and limit further uses and disclosures of such Protected Health
Information to those purposes that make the return or destruction infeasible, for so long as Business
Associate maintains such Protected Health Information.
VII. MISCELLANEOUS
a. No Rights in Third Parties. Except as expressly stated herein, the Parties to this Addendum do
not intend to create any rights in any third parties.
b. Survival. The obligations of Business Associate under Section VII(c) of this Addendum shall
survive the expiration, termination, or cancellation of this Addendum, the Agreement, and/or the business
relationship of the parties, and shall continue to bind Business Associate, its agents, employees, contractors,
successors, and assigns as set forth herein.
c. Amendment. This Addendum may be amended or modified only in a writing signed by the
Parties. The Parties agree that they will negotiate amendments to this Addendum to conform to any changes
in the HIPAA Privacy and Security Rules as are necessary for Covered Entity to comply with the current
requirements of the HIPAA Privacy and Security Rules. In addition, in the event that either Party believes
in good faith that any provision of this Addendum fails to comply with the then -current requirements of the
HIPAA Privacy and Security Rules or any other applicable legislation, then such Party shall notify the other
Party of its belief in writing. For a period of up to thirty (30) days, the Parties shall address in good faith
such concern and amend the terms of this Addendum, if necessary to bring it into compliance. If, after such
thirty (30)-day period, the Addendum fails to comply with the HIPAA Privacy and Security Rules or any
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other applicable legislation, then either Party has the right to terminate this Addendum and the Agreement
upon written notice to the other party.
d. Independent Contractor. None of the provisions of this Addendum are intended to create, nor
will they be deemed to create, any relationship between the Parties other than that of independent parties
contracting with each other solely for the purposes of effecting the provisions of this Addendum and any
other agreements between the Parties evidencing their business relationship.
e. Interpretation. Any ambiguity in this Addendum shall be resolved in favor of a meaning that
permits Covered Entity to comply with the HIPAA Privacy and Security Rules.
f. Certain Provisions Not Effective in Certain Circumstances. The provisions of this Addendum
relating to the HIPAA Security Rule shall not apply to Business Associate if Business Associate does not
receive any Electronic Protected Health Information from or on behalf of Covered Entity.
g. Ownership of Information. Covered Entity holds all right, title, and interest in and to the PHI
and Business Associate does not hold and will not acquire by virtue of this Addendum or by virtue of
providing goods or services to Covered Entity, any right, title, or interest in or to the PHI or any portion
thereof.
h. Entire Agreement. This Addendum is incorporated into, modifies and amends the Agreement,
inclusive of all other prior amendments or modifications to such Agreement. The terms and provisions of
this Addendum shall control to the extent they are contrary, contradictory or inconsistent with the terms of
the Agreement. Otherwise, the terms and provisions of the Agreement shall remain in full force and effect
and apply to this Addendum.
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IN WITNESS WHEREOF, the Parties have executed this Addendum as of the day and year written above.
Each person whose signature appears hereon represents, warrants and guarantees that he/she has
been duly authorized and has full authority to execute this Agreement on behalf of the party on
whose behalf this Agreement is executed.
Business Associate: Covered Entity:
EMS Management & Consultants, Inc.
Signed py:
By: - oL's5ansdco�oaa -
City of Elgin
I0
Print: Jay Gyure Print:
Title: chief Financial officer Title:
Date: 2/13/2025 Date: