HomeMy WebLinkAboutMINUTES - 09252001 - C.50 A
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TO: BOARD OF SUPERVISORS
FROM: William Walker, M.D. , Health Services Director -
`;. Contra
By: Ginger Marieiro, Contracts Administrator -
September 12 2001 e
Costa
DATE: P County
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SUBJECT: Approval of Contract Amendment Agreement #27-087-7 with C S6
Pharmaceutical Care Network (PCN)
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee
(Milt Camhi) , tc execute on behalf of the County, Contract Amendment
Agreement #27087-7 (as amended by Contract Amendment Agreement #27-
087-6) with Pharmaceutical Care Network (PCN) , effective October 1,
2001 to amend Contract #27-087-5, to modify the Service Plan to allow
Contractor to provide additional services, to be paid in accordance
with the attached revised rate schedule .
FISCAL IMPACT:
This Amendment will result in a savings to the County allowing
Contractor to provide an increase in claim volumes, above the existing
levels, which will allow the County to receive a reduced rate of $ . 02
per processed claim in excess of 20, 000 claims .
BACKGROUND/REASON(S) FOR RECOMMENDATION(S) :
The Health Plan has an obligation to provide certain specialized
professional health care services for its members under the terms of
their Individual and Group Health Plan membership contracts with the
County. Pharmaceutical Care Network (PCN) provides cost effective and
efficient distribution of needed pharmaceutical supplies to support the
health care needs of Health Plan members .
On January 18, 2000, the Board of Supervisors approved Contract #27-
087-5 (as amended by Contract Amendment Agreement #27-087-6) with
Pharmaceutical Care Network (PCN) , for the period from February 1, 2000
through January 31, 2002 , for the provision of pharmacy administration
services for the Contra Costa Health Plan.
Approval of this Contract Amendment Agreement #27-087-7 will modify the
Contract Service Plan, allowing Contractor to provide additional
pharmacy administration services at a reduced rate, through January 31,
2002 .
CONTINUED ON ATTACHMENT: YES SIGNATURE.
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMWNDATION OF BOARD COMMITTEE
_,—,--APPROVE _OTHER
SIGNATURES):
:
ACTION OF BOARD ON APPROVED AS RECOMMENDED X, OTHER
VOTE OF SUPERVISORS
v I HEREBY CERTIFY THAT THIS IS A TRUE
_ UNANIMOUS (ABSENT/YL ") AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED rJ Qj0
JOHN WEE. N,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: Milt Camhi (313-6004)
CC: Health Services Dept. (Contracts)
Auditor-Controller
Risk Management BY G DEPUTY
Contractor
BOARD ORDER
PAGE 2
REVISED FEE SCHEDULE
a. Allowed Charges. Allowed charges as provided in Service Plan
Exhibit A and the applicable Pharmaceutical Services Summary,
which is on file in the office of CCHP and may be periodically
modified by CCHP.
b. Base Administrative Fee. The greater of $350 . 00 per Check Write
Cycle or the applicable per processed claim fee listed below
multiplied by the number of claims processed by Contractor during
each Check Write Cycle :
Number of Processed Claims Per Per Processed
Check Write Cycle: Claim Fee:
0 - 2 , 500 $ .60 each claim
2 , 501 - 5, 000 .58 each claim
5, 001 - 7, 500 .56 each claim
7, 501 - 10, 000 .54 each claim
10, 001 - 12, 500 .52 each claim
12, 501 - 15, 000 .50 each claim
15, 000 - 20, 000 .48 each claim
20, 001 - 25, 000 .46 each claim
25, 001 - 30, 000 .44 each claim
30, 001 - 35, 000 .42 each claim
35, 001 - 40, 000 .40 each claim
40, 001 - 45, 000 .38 each claim
45, 001 + .36 each claim
C . Patient-Pay Claims Fee. $ 1.50 per claim for processing any
direct Patient-Beneficiary reimbursement claim.
d. Additional Services . The applicable fee rate per service as set
forth below:
(1) Manual Eligibility Processing
from Hard Copy $ 0 . 02 per claim
(2) Pharmaceutical Case Management $ 0 . 10 per member
(MicroDUR) (Retrospective DUR) /per month
(3) ID Card Group Re-issue $ 0 . 75 per card
(4) Claims Data Transfer $80 . 00 per tape
(5) Customized Introductory Brochure cost plus 10%
(6) Optional Reports listed in PCN Report Catalog
(a) First Copy of Each Report $25 . 00 per report
(b) Multiple Copies $15 . 00 per report
(after First Report) plus expenses
(7) Ad-Hoc Reports $110 . 00 per hour
(8) PC-Based Client Query Report Generator No Charge
(a) File Updates $110 . 00per transfer
(b) Application Modification $75 . 00 per hour
(c) System training at PCN site $75 . 00 per hour
(9) Physician Education Program $50 . 00 per review
e . Postage, Shipping, and Handling Charges . Actual postage,
shipping, and handling charges incurred directly by Contractor in
connection with the administration of this program, with the
exception of routine correspondence and report distribution, plus
10% .