HomeMy WebLinkAboutMINUTES - 09132005 - C127 TO: BOARD OF SUPERVISORS
William Walker,M.D.,Health Services Director ~
FROM: �� _ ��:.� ��`• Contra
By: Jacqueline Pigg,Contracts Administrator
Costa.
2005 `' -
DATE:
September �, � County
SUBJECT: Approval of Contract Cancellation Agreement#23-336-2 and Contract#23-336-3
with Toyon Associates,Inc.
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
"CONENIENDED ACTION:
Approve and authorize the Health Services Director,to execute as follows:
I. Contract Cancellation Agreement#23-336-2 with Toyon Associates,Inc.,a corporation,effective on the close of
business on June 30,2005,and
2. Contract#23-336-3 with Toyon Associates,Inc.,in an amount not to exceed$750,000,to provide consultation and
technical assistance to the Department with regard to Third Party Social Security Income(SSI)reimbursement recovery
and reviews of Medicare ratio of the disproportionate share calculations applicable to Contra Costa Regional Medical
Center, for the period from July 1,2005 through June 30,2007.
FISCAL IMPACT:
This Contract is included in the Health Services Department's Enterprise I Budget. This Contract is a contingent fee
contract. Contractor will be paid a fee of 23%of recoveries for fiscal years 1996 through 2005. Contractor will pursue on
behalf of Contra Costa Regional Medical Center, Medicare appeals of the following: (1) the Social Security Income
percentage and(2)the Medicare ratio. The Contractor will be paid 23%recoveries as a result of work that does not require
presentations before the Provider Reimbursement Review Board(PRRB). The Contractor will be paid 23%of recoveries
received as a result of work that does require presentations before the Provider Reimbursement Review Board
BACKGROUND/REASON(S)FOR RECOMIVVIENDATION(S):
On October 1, 2002, the Board of Supervisors approved Contract #23-336 (as amended by Contract Amendment
Agreement#23-336-1)with Toyon Associates,Inc.,to provide consultation and technical assistance to the department to
conduct reviews of the Medicare ratios to assess the maximum disproportionate share calculations, applicable to the
Hospital for all cost reporting years. Services provided under this Contract were to maximize the disproportionate share
adjustment to which the Hospital was entitled. Contractor's services included,but were not limited to,attending meetings,
preparing and file reopening of appeal requests, submit findings and make recommendations for submission to the
Hospital, for the period from October 1,2002 through September 30,2006.
The Department and the Contractor have mutually agreed to renegotiate the Contract to combine the services previously
provide under two separate Contracts under one Contract and allow Contractor to provide an additional level of Third Party
Social Security Income(SSI)reimbursement recovery. Therefore in accordance with Paragraph 3.(Term)of the Contract
#23-336(as amended by Contract Amendment Agreement#23-336-1),the Department and Contractor have agreed to a
mutual cancellation. Approval of Cancellation Agreement#23-336-2 will accomplish this termination.
Under Contract #23-336-3, the Contractor will provide professional consultation and technical assistance to the
Department with regard to Third Party Social Security Income(SSI)reimbursement recovery services and conduct reviews
of Medicare ratios for Contra Costa Regional Medical Centers through June 30,2007.
CONTINUED ON.ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS (ABSENT 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
JOHN SW TEN,CLERK OF TH BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: William Walker,M.D. (370-5007)
CC: Health Services Dept. (Contracts)
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