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HomeMy WebLinkAboutMINUTES - 07122011 - C.78RECOMMENDATION(S): Approve and authorize the Health Services Director, or his designee, to execute, on behalf of the County, Contract #23-336-8 with Toyon Associates, Inc., a corporation, in an amount of 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, 2011 through June 30, 2016. FISCAL IMPACT: This Contract is included in the Health Services Department's Enterprise I Budget. This Contract is a contingent fee contract. Contractor will pursue on behalf of Contra Costa Regional Medical Center, Medicare appeals. Contractor will be paid 23% of recoveries for Social Security Income and the Medicaid Ratio, subject to maximum payment limitations for each year being appealed; and 15% of recoveries for the appeals regarding the Medicare Prospective Payment System budget neutrality factor. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 07/12/2011 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Gayle B. Uilkema, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor Contact: George Washnak, 957-5440 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: July 12, 2011 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: Tasha Scott, Demetria Gary C. 78 To:Board of Supervisors From:William Walker, M.D., Health Services Director Date:July 12, 2011 Contra Costa County Subject:Contract #23-336-8 with Toyon Associates, Inc. BACKGROUND: On August 5, 2008, the Board of Supervisors approved Contract #23-336-6 (as amended by Amendment Agreement #23-336-7), 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 Contra Costa Regional Medical Center (CCRMC) for all cost reporting years. Services provided under this Contract maximize the disproportionate share adjustment to which the CCRMC 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 July 1, 2008 through June 30, 2011. Approval of Contract #23-336-8 will allow the Contractor to continue to provide professional consultation and technical assistance, through June 30, 2016. CONSEQUENCE OF NEGATIVE ACTION: If this contract is not approved, the Department will not be able to recover reimbursement due to CCRMC from Medicare appeals. CHILDREN'S IMPACT STATEMENT: Not applicable.