To: Board of Supervisors
From: DHHS: Behavioral Health
Agenda Section: Consent
Vote Requirement: Majority
SUBJECT:
title
Memorandum of Agreement with Livanta, LLC Regarding the Exchange of Data and Information Related to the Review of Inpatient and Outpatient Health Care Services Provided to Medicare Beneficiaries Residing in Humboldt County
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RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Approve, and authorize the Department of Health and Human Services - Behavioral Health Director, or a designee thereof, to electronically execute, the attached memorandum of agreement with Livanta, LLC regarding the exchange of data and information related to the review of inpatient and outpatient health care services provided to Medicare beneficiaries residing in Humboldt County;
2. Authorize the Department of Health and Human Services - Behavioral Health Director, or a designee thereof, to execute any and all subsequent amendments to the attached memorandum of agreement with Livanta, LLC, after review and approval by County Counsel, Risk Management and the County Administrative Office; and
3. Direct the Clerk of the Board to provide the Department of Health and Human Services - Contract Unit with one (1) fully executed certified copy of the Board order related to this item.
Body
SOURCE OF FUNDING:
Behavioral Health Fund
DISCUSSION:
The Quality Improvement Organization Program originated with the Peer Review Improvement Act of 1982 and is currently governed by Title XI and Title XVIII of the Social Security Act. The goal of the Quality Improvement Organization Program is to improve the quality of health care services provided to Medicare beneficiaries by addressing individual complaints and requests for Quality Improvement Organization review.
Section 1154(a) of the Social Security Act requires Quality Improvement Organizations to review health care services provided to Medicare beneficiaries by physicians and other healthcare practitioners and institutional and non-institutional providers of health care services. The Centers for Medicare and Medicaid Services (“CMS”) has designated Livanta, LLC as the Beneficiary and Family Centered Care - Quality Improvement Organization (“BFCC-QIO”) for California.
Pursuant to Section 1866(a) of the Social Security Act, the Humboldt County Department of Health and Human Services - Behavioral Health (“DHHS - Behavioral Health”) is required to maintain a memorandum of agreement with Livanta, LLC regarding the performance of certain review activities that are designed to ensure the validity of diagnostic information, the completeness, adequacy and quality of care provided to Medicare beneficiaries and the appropriateness of admissions and discharges.
The attached memorandum of agreement with Livanta, LLC sets forth the rights and responsibilities of DHHS - Behavioral Health and Livanta LLC regarding the exchange of data and information related to the statutorily mandated review of inpatient and outpatient health care services provided to Medicare beneficiaries residing in Humboldt County. The attached memorandum of agreement with Livanta, LLC shall be effective upon execution by both parties and shall remain in full force and effect so long as Livanta, LLC is a BFCC-QIO under contract with CMS for the CMS-identified region in which the County of Humboldt is located, or until terminated in accordance with the terms and conditions set forth therein.
Accordingly, DHHS - Behavioral Health recommends that the Board approve, and authorize the DHHS - Behavioral Director, or a designee thereof, to electronically execute, the attached memorandum of agreement with Livanta, LLC regarding the exchange of data and information related to the review of inpatient and outpatient health care services provided to Medicare beneficiaries residing in Humboldt County. It is also recommended that the Board authorize the DHHS - Behavioral Health Director, or a designee thereof, to execute any and all subsequent amendments to the attached memorandum of agreement with Livanta, LLC, after review and approval by County Counsel, Risk Management and the County Administrative Office, in order to avoid any unnecessary delays in the statutorily mandated review of the inpatient and outpatient health care services provided to Medicare beneficiaries residing in Humboldt County.
FINANCIAL IMPACT:
There are no direct costs associated with the attached memorandum of agreement with Livanta, LLC. As a result, approval of the attached memorandum of agreement with Livanta, LLC will not impact the Humboldt County General Fund.
STAFFING IMPACT:
There are no direct staffing impacts associated with the attached memorandum of agreement with Livanta, LLC.
STRATEGIC FRAMEWORK:
The recommended actions support the Board of Supervisors’ Strategic Framework by protecting vulnerable populations, creating opportunities for improved safety and health and providing community-appropriate levels of service.
OTHER AGENCY INVOLVEMENT:
Centers for Medicare and Medicaid Services
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may choose not to approve the attached memorandum of agreement with Livanta, LLC regarding the exchange of data and information related to the review of inpatient and outpatient health care services provided to Medicare beneficiaries residing in Humboldt County. However, this alternative is not recommended since it would cause DHHS - Behavioral Health to be out of compliance with Section 1866(a) of the Social Security Act.
ATTACHMENTS:
1. Memorandum of Agreement with Livanta, LLC Regarding the exchange of data and information related to the Review of Inpatient and Outpatient Health Care Services Provided to Medicare Beneficiaries Residing in Humboldt County
2. Livanta, LLC e-MOA Instructions
PREVIOUS ACTION/REFERRAL:
Board Order No.: N/A
Meeting of: N/A
File No.: N/A