TITLE
Recommendation to adopt Specifications No. RFP LW19-075 and award a contract to MEDEX Managed Care, Inc., of Newport Beach, CA, for providing Utilization Review services for the City of Long Beach Workers' Compensation Program, in an annual amount of $132,000, authorize a 20% contingency of $26,400, for a total annual contract amount not to exceed $158,400 for a period of two years, with the option to renew for three additional one-year periods, at the discretion of the City Manager; and, authorize City Manager, or designee, to execute all documents necessary to enter into the contract, including any necessary amendments. (Citywide)
DISCUSSION
City Council approval is requested to enter into a contract with Medex Managed Care, Inc. (MEDEX) to provide Utilization Review services, for the City of Long Beach Workers' Compensation Program. In January 2019, the professional services of Maureen Kohl Mahoney & Associates were enlisted to initiate a Request for Proposal (RFP) process to select a managed care vendor to provide Utilization Review (UR) through the City's Workers' Compensation Program.
UR services will be provided by MEDEX upon direct referral, for the review of medical treatment recommended by physicians for adherence to the American College of Occupational and Environmental Medicine (ACOEM) guidelines, the Medical Treatment Utilization Schedule (MTUS) or those treatment guidelines mandated by the State of California in accordance with any other medically accepted scientifically based ?guidelines. UR services are designed to provide the City of Long Beach (City) with tools to insure the City and the injured worker receives the reasonable and necessary medical care to treat Workers' Compensation injuries.
All eligible City employees are provided the best medical care available at the earliest time indicated, in addition to all appropriate workers' compensation indemnity benefits. In tandem, the City has a fiduciary responsibility to its citizens...
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