To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract Amendment #23-652-3 with Change Healthcare Technologies, LLC
Recommendation: Recommendation of the County Administrator
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Amendment No. 3 (Contract Amendment #23-652-3) with Change Healthcare Technologies, LLC, a limited liability company, effective October 6, 2026, to amend Contract #23-652 (as amended by Amendment No. 1 and 2 (Contract Amendment #23-652-1 and #23-652-2)), to increase the payment limit by $166,823, from $5,898,588 to a new payment limit of $6,065,411, with no change in the original term ending January 21, 2029, and extend the contract term for successive two (2) year periods until terminated, for additional InterQual software, maintenance and support services for Contra Costa Health (CCH).
FISCAL IMPACT:
Approval of this Amendment will result in additional expenditures of up to $166,823 and will be funded as budgeted by the department in FY’s 2026-29, by 100% Hospital Enterprise Fund I.
BACKGROUND:
Change Healthcare Technologies, LLC licenses InterQual software, an evidence-based clinical decision support solution to help payers, providers, and government agencies make clinically appropriate medical utilization decisions. Contra Costa Regional Medical Center (CCRMC) uses InterQual software and clinical content for performing medical necessity reviews. This software also helps determine appropriateness and level of admission, approximate length of stay, and determination of continued stay. The Contra Costa Health Plan (CCHP) has used InterQual since (at least) 2020 to ensure the appropriate utilization of resources and for medical necessity criteria. InterQual Exchange is an optional add-on to the InterQual® Connect™ Medical Review Service (Core) Product. The software will facilitate CCHP’s automation of the prior authorization process using InterQual® criteria. The Software is intended to streamline prior authorization capabilities and support compliance with the federal CMS0057 mandate. This software performs evidence-based criteria review for each prior authorization request.
This Contractor was approved by the Public Works Department’s Purchasing Division on July 15, 2025. CCH will monitor measurable service contract deliverables regarding CCH’s access to the software maintenance and support services in compliance with Section III(B)(7) of the Purchasing Policy. CCH Personnel approved this amendment to ensure no conflict with labor relations.
On December 8, 2020, the Board of Supervisors approved Contract #23-652 with Change Healthcare Technologies, LLC, in an amount not to exceed $878,803 for the provision of software licenses and services regarding its InterQual software, for the period from January 22, 2020, through January 21, 2023.
On February 7, 2023, the Board of Supervisors approved Amendment No. 1 (Contract Amendment #23-652-1) with Change Healthcare Technologies, LLC, effective January 21, 2023, to increase the payment limit by $1,197,192 to a new payment limit of $2,075,995, and extend the term through January 21, 2026 for additional software licensing, support and services.
On November 18, 2025, the Board of Supervisors approved Amendment No. 2 (Contract Amendment #23-652-2) with Change Healthcare Technologies, LLC, effective August 1, 2025, to increase the payment limit by $3,822,593 to a new payment limit of $5,898,588, and extend the termination date through January 21, 2029 for additional software licensing, support and services for Contra Costa Health.
Approval of this Amendment No. 3 (Contract Amendment #23-652-3) will add InterQual® Exchange Product at the Contra Costa Health Plan Facility (only), allowing the Contractor to provide additional products and InterQual software licensing and services with no change in the term ending January 21, 2029, and for successive two (2) year periods thereafter until terminated.
CONSEQUENCE OF NEGATIVE ACTION:
If this Amendment is not approved, CCH will be out of compliance with federal and state regulatory bodies regarding CCRMC and CCHP case management and utilization review. The potential of non-compliance may result in adverse effects such as financial losses, license revocations, business disruptions, and poor quality of patient care.