To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract #77-827 with Divya Gupta MD Inc.
☒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 #77-827 with Divya Gupta MD Inc., a professional corporation, in an amount not to exceed $400,000, to provide Medical Management Physician services to the Contra Costa Health Plan (CCHP) Medical Management Team, with regard to policies and procedures used by CCHP’s Utilization Management (UM) program, for the period July 1, 2026 through June 30, 2028.
FISCAL IMPACT:
Approval of this Contract will result in contractual service expenditures of up to $400,000 over a 2-year period and will be funded 100% by CCHP Enterprise Fund II revenues.
BACKGROUND:
CCHP has an obligation to provide certain specialized healthcare services for its members under the terms of their Individual and Group Health Plan membership Contracts with the County. This Contractor will begin providing Medical Management Physician services, including UM subject matter expertise, and guidance and leadership, to the CCHP Medical Management Team with regard to CCHP’s best practices, policies and procedures used by UM staff while fostering a deep understanding of CCHP’s organization’s mission, values and long-term objectives beginning July 1, 2026.
Contractor’s Medical Management Physician services are essential to ensure that CCHP is meeting and following the Medi-Cal Managed Care Plan requirements from the State of California Department of Managed Health Care (DMHC) and Department of Health Care Services (DHCS). This Contract is entered into under and subject to the following legal authorities: California Government Code §§ 26227 and 31000; Health and Safety Code § 1451; and 42 CFR 432.10(a) Standards of Personnel Administration. Health Services Personnel approved this Contract to ensure no conflicts with labor relations. The nature of the Medical Management Physician services needed is complex and requires seamless coordination, integration and collaboration with existing programs and systems. Per Administrative Bulletin 600.3, CCHP Physician services are exempt from solicitation requirements.
Approval of new Contract #77-827 will allow the Contractor to provide Medical Management Physician services to the CCHP Medical Management team through June 30, 2028. This Contract was delayed due to extended Contract negations between Contractor and Division.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract is not approved, the CCHP Medical Management Team will not receive the benefits of the Medical Management Physician services from the Contractor and state mandated requirements may not be met.