To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Amendment #77-592-1 with Symplr Care Management, LLC
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract Amendment Agreement #77-592-1 with Symplr Care Management, LLC, a limited liability company, effective November 1, 2024, to amend Contract #77-592, for additional credentialing support services with regard to Conta Costa Health Plan’s (CCHP) healthcare operations, with no change in the payment limit of $900,000 or the original term of September 1, 2023 through August 31, 2026.
FISCAL IMPACT:
Approval of this Amendment will not impact the payment limit of $900,000 and is funded 100% by Contra Costa Health Plan (CCHP) Enterprise Fund II revenues.
BACKGROUND:
This Contract meets the needs of the County by providing CCHP with services regarding its healthcare operations by increasing the efficiency of credentialing medical providers contracted in CCHP's Provider Network. CCHP is mandated by its contracts with Department of Health Care Services (DHCS) and Department of Managed Health Care (DMHC) to use a National Committee for Quality Assurance certified vendor to perform primary source verification on all providers and vendors who will deliver services to CCHP Members. Symplr Care Management, LLC, was chosen for its expertise in the field, and response time of the primary source verification process and issued a single source status for this contract. Contractor has been fostering a deep understanding of the CCHP organizations mission, values, and long-term objectives since September 2023. This Contract is entered into under and subject to the following legal authorities: California Government Code §§ 31000. Health Services Personnel approved this Contract to ensure no conflicts with labor relations
On June 27, 2023, the Board of Supervisors approved Contract #77-592 with Symplr Care Management, LLC, in an amount not to exceed $900,000, for the provision of credentialing services for healthcare providers contracted in CCHP's Provider Network for the period July 1, 2023, through June 30, 2026.
On September 12, 2023 (C.64) the Board of Supervisors approved to rescind prior Board Action for Contract #77-592 to revise the term of the Contract to September 1, 2023 through August 31, 2026 and with no change in the contract payment limit. This Board Action also clarified that under the Contract, contained mutual indemnification with Symplr Care Management, LLC, and the Contract also included limited liability provisions.
Approval of Contract Amendment Agreement #77-592-1 will allow the Contractor to modify the Contract service plan provisions to conform with the additional DMHC requirements and provide additional services through August 31, 2026.
CONSEQUENCE OF NEGATIVE ACTION:
If this Amendment is not approved, County will not be compliant with DMHC requirements.