On January 1, 2022, the State required Health Plans to submit a new Quarterly Financial Report to the Department of Health Care Services (DHCS) State oversight agency. New State mandates also require Medi-Cal Managed Care Health Plans to report information related to plan members who have Other Health Care Coverage (OHC), and account for refunds due from providers for medical claim overpayments. The department must also address the additional work created by CalAIM and the additional work associated with a proposal to convert the Contra Costa Health Plan from a Medi-Cal two plan model to a single plan County Organized Health System model. The department plans to add additional accounting staff to absorb these new mandates and reporting requirements.   
  
Management has determined the addition of a Health Services Reimbursement Accountant will provide the appropriate level of management to bring on new staff, provide appropriate training and cross-training to staff, and carve out some of the routine monthly and quarterly work to enable the unit to address the new State reporting requirements in a timely manner, which is critical to the proposal to convert CCHP to a single plan model. This additional position would enable the unit manager to focus on the critical rate development reporting and the quarterly financial reporting. There are also increased state and federal reporting obligations for the Community Health Plan. This plan includes commercial coverage for County employees and retirees, and the State-sponsored coverage available to in-home supportive service providers in Contra Costa County. Supervisory oversight is needed to manage the process for setting premium rates and monitoring Pharmacy costs.

If this request is not approved, the Department will not have the proper management staffing levels to meet the financial reporting requirements mandated by the State.