Agenda

Return

C. 52

To:	Board of Supervisors
From:	William Walker, M.D., Health Services Director
Date:	April 21, 2015

Contra

Costa

County

Subject:

Contract #27–799–4 with Health Management Systems, Inc.

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 04/21/2015

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

ABSENT:

Federal D. Glover, District V Supervisor

Contact:	Patricia Tanquary 313-6004
cc:	A Floyd C Rucker

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: April 21, 2015
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

Approve and authorize the Health Services Director, or his designee, to execute, on behalf of the County, Contract #27–799–4 with Health Management Systems, Inc., a corporation, in an amount not to exceed $650,000, to provide auditing services to Contra Costa Health Plan for the period from February 1, 2015 through January 31, 2017.

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 non-compliance with the Centers for Medicare and Medicaid Services (CMS) program requirements. On March 12, 2013 the Board of Supervisors approved Contract #27-799-2 (as amended by Contract Amendment Agreement #27-799-3) with Health Management Systems, Inc., for the period from February 1, 2013 through January 31, 2015 for the provision of professional auditing services. Approval of Contract #27–799–4, 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 July 31, 2017. This contract includes modifications to Paragraph 18 of the General Conditions, including mutual indemnification.

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.

CHILDREN'S IMPACT STATEMENT:

Not Applicable