To: Board of Directors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract Amendment #27-633-30 with PerformRx, 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 #27-633-30 with PerformRx, LLC, a limited liability company, effective January 1, 2026, to amend Contract #27-633-24 (as amended by Contract Amendments #27-633-26, #27-633-27, and #27-633-28), to provide additional pharmacy program administration services and include additional contract provisions to comply with Federal Centers for Medicare and Medicaid Services (CMS) requirements, with no change in the payment limit of $70,000,000 or term ending December 31, 2026.
FISCAL IMPACT:
Approval of this Contract Amendment will not result in additional expenditures and remains funded 100% by Contra Costa Health Plan (CCHP) Enterprise Fund III revenues. (No rate increase)
BACKGROUND:
Both the State Department of Health Services and the Federal CMS require a Pharmacy Benefits Manager that can develop, maintain, and manage a large pharmacy network and monitor the correct dispensing of drug benefits and co-pays under multiple group product lines while adhering to the required Health Plan Formulary and Health Plan Prior authorization protocol. This Contractor has been providing these services and fostering a deep understanding of the CCHP organizations mission, values, and long-term objectives since May 1, 2006.
This Contract is entered into under and subject to the following legal authorities: California Government Code ?? 26227 and 31000; Health and Safety Code ? 1451. Health Services Personnel approved this Contract to ensure no conflicts with labor relations. Contractor was selected to provide pharmacy program administration services to CCHP's Pharmacy and Utilization Units and help establish and maintain a Utilization Man...
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