Agenda

Return

C.34

To:	Board of Supervisors
From:	William Walker, M.D., Health Services Director
Date:	November 8, 2011

Contra

Costa

County

Subject:

Correct September 20, 2011 Board Order Item #C.54 with Health Management Systems, Inc.

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 11/08/2011

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:	Patricia Tanquary, 313-6008
cc:	A Down D Gary

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: November 8, 2011
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

Correct the Board Order which was approved by the Board of Supervisors on September 20, 2011, Agenda Item C.54, Contract #27-799-1 with Health Management Systems, Inc., a corporation, to reflect the intent of the parties in which the Payment Limit is increased from $25,000 to an amount not to exceed $75,000 and to correct the term of the Contract from August 1, 2011 through July 31, 2012 to read August 1, 2011 through January 31, 2013 to provide professional auditing services to Contra Costa Health Plan.

FISCAL IMPACT:

This Contract is funded 100% by Health Plan member premiums. No change in the rate.

BACKGROUND:

On September 20, 2011, the Board of Supervisors approved Contract #27-799-1 with Health Management Systems to provide professional auditing services including fraud, waste, and abuse services, coordination of benefits, and overpayment recovery services for the Health Plan, through July 31, 2012, including mutual indemnification to hold harmless both parties for any claims arising out of the performance of this Contract.

BACKGROUND: (CONT'D)

The purpose of this Board Order is to correct the payment limit of the contract from $25,000 to $75,000 and also to correct the term of the contract to allow Contractor to provide services through January 31, 2013.

CONSEQUENCE OF NEGATIVE ACTION:

If this contract is not approved, the Health Plan will be out of compliance with a Medi-Cal Audit Corrective Action Plan requirement to provide evidence that policies and procedures to comply with Fraud and Abuse reporting requirements have been implemented, that monitoring tools and controls to detect fraud and abuse have been utilized, and that a more proactive fraud and abuse detection and intervention program has been developed and implemented.

CHILDREN'S IMPACT STATEMENT:

Not applicable.