Agenda

Return

C.108

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	April 20, 2021

Contra

Costa

County

Subject:

Amendment #27-633-19 with PerformRx, LLC

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 04/20/2021

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:	Kathleen Cyr Marcy 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: April 20, 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 Amendment Agreement #27-633-19 with PerformRx, LLC , a limited liability company, effective April 1, 2021, to amend Contract #27-633-18, to remove the revised Pharmacy Benefit Management Services in accordance with Department of Health Care Services (DHCS) requirement with no change in the payment limit of $119,000,000 and no change in the original term of January 1, 2021 through December 31, 2021.

FISCAL IMPACT:

Approval of this amendment will result in no change to the annual expenditures of up to $119,000,000 and will be funded, as budgeted by the department in FY 2020-21, by 100% Contra Costa Health Plan Enterprise Fund II. (No rate increase)

BACKGROUND:

Both the State Department of Health Services and the Federal Centers for Medicare and Medicaid Services (CMS) require a Pharmacy Benefits Manager that can develop, maintain, and manage a large pharmacy network and monitor the correct dispensing of drug benefits, co-pays under multiple group product lines adhering to the required Health Plan Formulary and Health Plan Prior Authorization Protocol.

On January 5, 2021, the Board of Supervisors approved Contract #27-633-18, with PerformRx in the amount of $119,000,000, to provide pharmacy administration services for CCHP members, including drug utilization review and management, prior authorization procedures, account management, member pharmacy call center, analysis and reporting services, and developing partnerships with prescribers and pharmacies, for the period from January 1, 2021 through December 31, 2021. This contract includes mutual indemnification.

Approval of Contract Amendment Agreement #27-663-19 will allow the County and Contractor to remove Pharmacy Benefit Management Services that were anticipated to be effective April 1, 2021, but were rescinded by the DHCS with no replacement date received from the DHCS as of April 1, 2021. There is no change in the payment limit of $119,000,000 and no change in the term of January 1, 2021 through December 31, 2021.

CONSEQUENCE OF NEGATIVE ACTION:

If this amendment is not approved, revisions to the Pharmacy Benefit Management Services will not occur, and both the contractor and County will not be compliant with the DHCS’s current services.