Item Description:
title
Amd 3 to Agmt PR00002295 with Federal Hearings and Appeals Services, LLC, to provide external appeal review services to Hennepin Health, ext end date to 06/30/30, incr NTE by $105,000 for a new total NTE of $192,000
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Resolution:
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BE IT RESOLVED, that Amendment 3 to Agreement PR00002295 with Federal Hearings and Appeals Services, LLC, to provide external appeal review services to Hennepin Health, extending the contract period through June 30, 2030, increasing the not to exceed amount by $105,000 for a new total not to exceed amount of $192,000 be approved; that the Chair of the Board be authorized to sign the Agreement on behalf of the County; and that the Controller be authorized to dispense funds as directed.
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Background:
Agreement PR00002295 with Federal Hearings and Appeals Services, LLC is to provide same/similar specialty medical necessity appeal reviews by board-certified physicians within a specific timeframe. Federal Hearings and Appeals Services, LLC was selected to provide external appeal review services to Hennepin Health in 2020 as a result of open competitive RFP process.
Hennepin Health contracts with the Department of Human Services (DHS) and the Minnesota Utilization Management (UM) Statutes require that a medical reviewer, different from the one that performed the initial UM determination, review medical necessity appeals.
Amendment 3 to Agreement PR00002295 with Federal Hearings and Appeals Services, LLC seeks approval to extend the end date to June 30, 2030 and increase the NTE $192,000.
This board action request aligns with Hennepin County disparity reduction efforts to improve access to culturally specific/sensitive health services and increase community well-being.
recommendation
Recommendation from County Administrator: Recommend Approval