TITLE
Recommendation to authorize City Manager, or designee, to execute all documents necessary to amend Agreement No. 33242 with Excel Managed Care & Disability Services, Inc. (EXCEL) to provide Utilization Review services and Agreement No. 33243 with Rehab West, Inc. (RWI) to provide Medical Case Management services for the City of Long Beach Workers' Compensation Program, and extend the contract terms until September 30, 2019, in a total amount not to exceed $212,000. This approval will allow for continuation of Workers' Compensation Utilization Review services and Medical Case Management services pending a Request for Proposal process anticipated to be released approximately in the month of February 2019.
DISCUSSION
On August 13, 2013, the City Council awarded Agreement No. 33242 with Excel Managed Care and Disability Services, Inc. (EXCEL) to provide Utilization Review services and Agreement No. 33243 with Rehab West, Inc. (RWI) to provide Medical Case Management services for the City of Long Beach Workers' Compensation Program (Program). In September 2012, through the City's Risk Management Division, the professional services of Maureen Kohl Bennington & Associates were enlisted to initiate a Request for Proposal (RFP) process to select a managed care vendor. The scope of work in the RFP was to provide select managed care services, to include utilization review (UR) and medical case management (MCM) through the City's Workers' Compensation Program.
Utilization Review services are provided by EXCEL to the City's Workers' Compensation Program upon direct referral, for the review of medical treatment recommended by physicians. These services are designed to provide the injured worker with reasonable and necessary medical care to treat Workers' Compensation injuries.
Medical Case Management services are provided by RWI to the City's Workers' Compensation Program upon direct referral, in the form of telephonic, field, or task-based case management. These ...
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