Health pact's $405,000 OK'd

Lawmakers trim request for care-coordination contract

A legislative committee on Wednesday signed off on a $405,000 increase to a contract with a company that helps doctors improve how they coordinate patient care.

The unanimous vote by the Legislative Council's Review Subcommittee to "review" the increase in the state Department of Human Services' contract with Seattle-based Qualis Health came after Sen. Missy Irvin, R-Mountain View, said department officials had answered her questions about the contract.

She also noted that the amount of the increase had been reduced from the $600,000 that the department originally requested.

"Today we're saving taxpayer dollars," Irvin said.

The Human Services Department hired Qualis to help medical practices meet the requirements of the patient-centered medical home program.

The program provides practices that agree to take steps to improve patient care coordination with quarterly payments from the state's Medicaid program.

Qualis is paid $1 for each patient who is assigned to a practice that it helps. The contract allows it to be paid a total of $1.2 million for work from Jan. 1 through the end of this year.

At a subcommittee meeting last month, Lech Matuszewski, the Medicaid program's business operations manager, said the original contract amount wasn't enough because more physician practices than expected had signed up for the program.

He said the department needed an additional $400,000, but had requested $600,000 "just to make sure we have enough."

At Irvin's request, the subcommittee on Sept. 3 declined to review the request for the increase. The Legislative Council on Sept. 19 sent the request back to the subcommittee and allowed it to have the final review of the request.

Qualis and three other companies have submitted proposals to help practices meet the program's requirements starting Jan. 1. The Human Services Department expects to award contracts to two of the companies, Matuszewski has said.

Also Wednesday, with little discussion, the subcommittee reviewed the department's $9.3 million contract with DataPath to administer "independence accounts" for participants in the so-called private option.

Under the private option, the state uses Medicaid funds to buy insurance for adults with incomes of up to 138 percent of the poverty level.

The independence account program, which must be approved by the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services, would encourage enrollees with incomes greater than 50 percent of the poverty level to make monthly payments, ranging from $5 to $25, to help pay the cost of their medical care.

Enrollees would be allowed to accumulate up to $200 that could be used to pay the premiums for health insurance when they leave the private option.

Special language passed by the state Legislature this year requires the independence account program to be in place by Feb. 1 of next year.

Metro on 10/02/2014

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