Agenda

Return

C. 55

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	February 2, 2021

Contra

Costa

County

Subject:

Contract #27–799–11 with Health Management Systems, Inc.

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 02/02/2021

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:	Sharron Mackey, 925-313-6104
cc:	Leslie Walker 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 2, 2021
Monica Nino, County Administrator

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract #27–799–11 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 (CCHP), for the period from January 1, 2021 through December 31, 2023.

FISCAL IMPACT:

This contract will result in contractual service expenditures of up to $3,000,000 over a 3 year period and will be funded 100% by CCHP Enterprise Fund II revenues.

BACKGROUND:

CCHP 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 February 7, 2017, the Board of Supervisors approved Contract #27-799-6 with Health Management Systems, Inc., for the period from February 1, 2017 through January 31, 2019 for the provision of professional auditing services. On February 6, 2018, the Board of Supervisors approved Amendment Agreement #27-799-7 to add additional auditing service activities with no change to the payment limit of $3,000,000 or term. On May 5, 2018, the Board of Supervisors approved Amendment/Extension Agreement #27-799-8 to increase the payment limit by $300,000 to a new payment limit of $3,300,000 and extend the termination date from January 31, 2019 to December 31, 2020. On January 7, 2020, the Board of Supervisors approved Amendment Agreement #27-799-9 to add additional auditing service activities with no change to the payment limit of $3,300,000 or term.

Approval of Contract #27–799–11, will allow the contractor to continue to provide professional auditing services, including fraud, waste, and abuse services, coordination of benefits, and overpayment recovery services for CCHP, through December 31, 2023.

CONSEQUENCE OF NEGATIVE ACTION:

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