To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Rescind Prior Board Action Pertaining to Contracted Services with Cotiviti, Inc.
?Recommendation of the County Administrator ? Recommendation of Board Committee
RECOMMENDATIONS:
Board action of April 14, 2026 (C.61), which pertained to a contract amendment with Cotiviti, Inc.; and APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract Amendment #27-791-15 with Cotiviti, Inc., a corporation, effective April 28, 2026, to amend Contract #27-791-14, to increase the payment limit by $2,250,000, from $3,000,000 to a new payment limit of $5,250,000, and to extend the termination date from October 31, 2028 to October 31, 2029 for additional code editing and validation capabilities concerning its hosted software solution for analyzing Healthcare Effectiveness Data and Information Sets (HEDIS) for fraud, waste and abuse for Contra Costa Health Plan (CCHP).
FISCAL IMPACT:
Approval of this Contract Amendment will result in additional contractual service expenditures of up to $2,250,000 and will be budgeted by the department in FY's 2026-29 and will be funded 100% by CCHP Enterprise Fund II revenues.
BACKGROUND:
This Contract Amendment meets the needs of the County by providing proprietary data analysis software for HEDIS projects and reports to support State and contractual requirements for CCHP. Cotiviti, Inc., provides its licensed program, Quality Intelligence, used by CCHP to calculate and analyze HEDIS measures. HEDIS Measures, are a requirement for accreditation certification with the National Committee for Quality Assurance (NCQA) and mandated by the Department of Health Care Services, for which CCHP is assessed. HEDIS scores are used to determine Plan assignment, and therefore impact capitation payments from the state. HEDIS is also utilized for Quality Rate Factor payments in which capitation is not only based on monthly ...
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