To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Amendment #77-217-5 with Healthrisk Resource Group, 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 Amendment Agreement #77-217-5, with Healthrisk Resource Group, Inc., a corporation, effective May 1, 2024, to amend Contract #77-217-4, to modify contract provisions to conform to Department of Managed Healthcare (DMHC) requirements with no change in the contract payment limit of $300,000 or the original term of March 1, 2024 through February 28, 2027.
FISCAL IMPACT:
Approval of this amendment will not result in additional funding and remains funded 100% by Contra Costa Health Plan (CCHP) Enterprise Fund II.
BACKGROUND:
Healthrisk Resource Group, Inc. has been providing claims processing and negotiation services for CCHP since March 2019. This contractor acts as a billing agent to negotiate discount rates, review documentation of medical claims and electronic claims from out of network medical providers services, which results in saving dollars for CCHP.
On March 19, 2024, the Board of Supervisors approved Contract #77-217-4 with Healthrisk Resource Group, Inc., in the amount of $300,000 for the provision of acting as a billing agent to negotiate discount rates by reviewing documentation of medical claims and electronic claims from out of network medical providers to complete claims and provide payment to County for completed claims, for the period March 1, 2024 through February 28, 2027.
Approval of Contract Amendment Agreement #77-217-5 will allow the contractor to modify contract provisions to conform with the DMHC requirements with no change in the payment limit or term through February 28, 2027.
CONSEQUENCE OF NEGATIVE ACTION:
If this amendment is not approved, County will not be compliant with DHCS requirement...
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