Number
040747
Version
SUBSTITUTE 1
Reference
Sponsor
ALD. DONOVAN
Title
Substitute resolution reserving a $95,000 appropriation in the Common Council Contingent Fund for transfer to the City Attorney Damages and Claims Fund to pay Medicare and various other healthcare plan providers for reimbursements erroneously paid to the City.
Analysis
This resolution:
1. Reserves a $95,000 appropriation in the Common Council Contingent Fund for transfer to the Damages and Claims Fund to pay Medicare and various other healthcare plan providers for reimbursements erroneously paid to the City.
2. Directs the Comptroller to review the Milwaukee Fire Department's financial records for erroneous reimbursements to verify the total amounts that were improperly paid to the City of Milwaukee and are now claimed by Medicare and various other healthcare provider plans, including United Healthcare.
3. Directs the Comptroller to issue a check to Medicare and the various other healthcare plan providers in the amount the City received in error.
Body
Whereas, United Healthcare is a health care provider, and the Milwaukee Fire Department (MFD) provided emergency medical services (EMS) to individuals who participate in United Healthcare's health plans, as well as various other healthcare plans; and
Whereas, MFD is eligible for reimbursement from United Healthcare and various other healthcare plan providers for the emergency medical services the department provided; and
Whereas, MFD issued its claims for reimbursement, but United Healthcare and various other healthcare plan providers did not issue reimbursement on a timely basis, which resulted in the department making duplicate claims; and
Whereas, United Healthcare and various other healthcare plan providers overpaid the City by reimbursing the City on the duplicate and the original claims; and
Whereas, These healthcare plan providers estimate they overpaid the City approximately $32,000; and
Whereas, On a similar matter, the fire departments of both the City of Milwaukee and the City of Menomonie used Claims, Processing and Receivables (CPR), Inc. of 5225 North Ironwood Road, Glendale, Wisconsin, for their respective EMS billing, collection and data management services; and
Whereas, CPR, Inc. erroneously gave the City of Milwaukee's Medicare Provider Number and Tax Identification Number to various billing services; and
Whereas, The MFD, consequently, received the Medicare reimbursements for services provided by the City of Menomonie Fire Department; and
Whereas, It is estimated said erroneous reimbursements to the City of Milwaukee amount to approximately $52,000; and
Whereas, The City's erroneous reimbursements were placed in the City's General City Purposes Fund; now, therefore, be it
Resolved, By the Common Council of the City of Milwaukee, that the sum of $95,000 shall be reserved within the 2004 Common Council Contingent Fund (Account Number 0001-9990-0001-C001-006300-2004) for the City Attorney Damages & Claims Fund (Account Number 0001-1490-0001-S118-006300-2004) for the purposes of paying on claims by Medicare, United Healthcare and various other healthcare plan providers; and, be it
Further Resolved, That the City Comptroller and City Attorney are authorized to review the Milwaukee Fire Department's financial records as they relate to the reimbursement errors to determine that the respective claims made by Medicare, United Healthcare and various other healthcare plan providers are correct, and to determine the exact amounts the City must pay to each; and, be it
Further Resolved, That the City Comptroller is authorized to appropriate on an as-needed basis up to $95,000 from the funds reserved within the Common Council Contingent Fund to the City Attorney Damages and Claims Fund for the purpose of paying expenditures relating to the claims mentioned above.
Requestor
Drafter
LRB 04313-2 (mcw)
TWM/cac
10/05/2004