Agenda

Return

C. 56

To:	Board of Supervisors
From:	William Walker, M.D., Health Services Director
Date:	February 7, 2017

Contra

Costa

County

Subject:

Contract #27–799–6 with Health Management Systems, Inc.

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 02/07/2017

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Patricia Tanquary, 925-313-6004
cc:	D Morgan M Wilhelm

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: February 7, 2017
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

Approve and authorize the Health Services Director, or his designee, to execute, on behalf of the County, Contract #27–799–6 with Health Management Systems, Inc., a corporation, in an amount not to exceed $3,000,000, to provide auditing services to Contra Costa Health Plan for the period from February 1, 2017 through January 31, 2019.

FISCAL IMPACT:

This Contract is funded 100% by Contra Costa Health Plan Enterprise Fund II. (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 (CMS) program requirements.

BACKGROUND: (CONT'D)

On March 30, 2015, the Board of Supervisors approved Contract #27-799-4 (as amended by Contract Amendment Agreement #27-799-5) with Health Management Systems, Inc., for the period from February 1, 2015 through January 31, 2017 for the provision of professional auditing services.

Approval of Contract #27–799–6, will allow Contractor to continue to provide professional auditing services, including fraud, waste, and abuse services, coordination of benefits, and overpayment recovery services for the Health Plan, through January 31, 2019.

CONSEQUENCE OF NEGATIVE ACTION:

If this contract is not approved, the Health Plan will be out of compliance with Medi-Cal Audit Corrective Action Plan requirements.