HomeMy WebLinkAboutMINUTES - 07082014 - C.80RECOMMENDATION(S):
Approve and authorize the Health Services Director, or his designee, to execute, on behalf of the County, Contract
Amendment Agreement #27-799-3 with Health Management Systems, Inc., a corporation, effective July 1, 2014, to
amend Contract #27-799-2, to increase the payment limit by $180,000, from $75,000 to a new payment limit of
$255,000, with no change in the original term of February 1, 2013 through January 31, 2015.
FISCAL IMPACT:
This amendment is funded 100% by Health Plan member premiums. (No rate increase)
BACKGROUND:
Contra Costa Health Plan is mandated by State and Federal law to have a comprehensive fraud, waste, and abuse
prevention and detection program which must include measures that prevent, detect, and correct noncompliance with
the Centers for Medicare and Medicaid Services
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 07/08/2014 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I Supervisor
Candace Andersen, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
Federal D. Glover, District V
Supervisor
Contact: Patricia Tanquary,
313-6004
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 8, 2014
David Twa, County Administrator and Clerk of the Board of Supervisors
By: Chris Heck, Deputy
cc: A Down, C Rucker
C. 80
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:July 8, 2014
Contra
Costa
County
Subject:Amendment #27-799-3 with Health Management Systems, Inc.
BACKGROUND: (CONT'D)
(CMS) program requirements.
On March 12, 2013, the Board of Supervisors approved Contract #27-799-2 with Health Management Systems, Inc.
for the provision of professional auditing services, for the period from February 1, 2013 through January 31, 2015.
At the time of negotiations, the payment limit was based on target levels of utilization. However, based on revised
projections, actual usage will exceed the target levels by end of the Contract term.
Approval of Contract Amendment Agreement #27-799-3 will allow the Contractor to provide additional services
through January 31, 2015.
CONSEQUENCE OF NEGATIVE ACTION:
If this amendment is not approved, the Health Plan will be out of compliance with Medi-Cal Audit Corrective Action
Plan requirements.
CHILDREN'S IMPACT STATEMENT:
Not Applicable.