RECOMMENDATION(S):

APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract #77-462 with Varis, LLC., a limited liability corporation, in an amount not to exceed $900,000, to identify Medi-Cal claims overpayment identification for the Contra Costa Health Plan (CCHP), for the period from April 1, 2022 through March 31, 2025.

FISCAL IMPACT:

This contract will result in contractual service expenditures of up to $900,000 over a 3-year period and will be funded 100% by CCHP Enterprise Fund II.

BACKGROUND:

Under this new Contract #77-462, Varis, LLC will provide overpayment identification services, reporting and virtual education for CCHP staff, through March 31, 2025. Varis will report to CCHP any claims where a retrospective overpayment has been identified so county can begin overpayment collection efforts. These services will result in cost savings for CCHP.

CONSEQUENCE OF NEGATIVE ACTION:

If this contract is not approved, CCHP will not save money from this contractor's identification of overpaid inpatient claims.