Lawmakers balk at $600,000 more for patient-coordinating firm

A legislative panel Wednesday declined to sign off on adding $600,000 to a contract with a company that helps doctors improve how they coordinate patient care.

The action by the Legislative Council's Review Subcommittee on the Department of Human Services' contract with Seattle-based Qualis Health came after some members questioned how the contract was awarded and how many Arkansans the company employs.

On a voice vote, the subcommittee approved a motion by Sen. Missy Irvin, R-Mountain View, to not review the contract. No members could be heard voting against the motion.

Sen. David Sanders, R-Little Rock and a subcommittee chairman, said he would attempt to get answers to legislators' questions from the Human Services Department before the contract, part of the state's patient-centered medical home initiative, goes to the full Legislative Council on Sept. 19.

"I think overall what we've seen out of the patient-centered medical home has been positive and [I] feel confident that the agency will be able to get us the requested information," Sanders said.

Under the initiative, medical practices can receive quarterly payments from the state's Medicaid program in exchange for taking steps such as making sure patients get preventative health screens, by coordinating care among providers and providing around-the-clock access to a medical professional.

The payments average about $4 per patient per month.

The Human Services Department hired Qualis to help practices meet the program's requirements.

The company is paid $1 per month for each patient who is assigned to a practice that it assists.

Lech Matuszewski, the Medicaid program's business operations manager, said the department's contract allows the company to be paid a total of $1.2 million for its work from Jan. 1 through the end of this year. Half of the money for the contract comes from the federal government, with the rest coming from the state.

Matuszewski said the department expects all but about $80,000 of that amount to be spent after this month, when the Medicaid program makes a monthly payment of about $150,000 for work that Qualis performed in August.

The reason for the shortfall, he said, is that more practices have been using the company's services than the department expected.

The department expected about 40 percent of eligible practices in the state to participate in the initiative, but about 70 percent have signed up, he said.

Of the 120 practices that are participating, 68 are using Qualis' services, he said.

"For lack of a better word, we're a victim of our own success," Matuszewski said.

He said the department expects to need an additional $400,000 to pay Qualis through the end of this year, but $600,000 was requested "just to make sure we have enough."

"We promise practices that they will be able to receive practice transformation services at no cost to them," Matuszewski said. "That was the promise of the program, and so essentially for all practical purposes, if we cannot continue through October, we'll have to break that promise."

Irvin said she was concerned that Qualis was hired through a sole-source contract.

Matuszewski said other companies submitted proposals, but Qualis was the only bidder deemed to be qualified. For 2015, he said the department has solicited proposals from other companies and expects to award contracts to two of them.

The companies that have submitted proposals, he said, are Qualis, the Arkansas Foundation for Medical Care, Community Care of North Carolina and Leawood, Kan.-based TransforMed.

Irvin also disagreed with an assertion by Matuszewski that Qualis is providing worthwhile services to doctors, saying it is "not really what I hear from the street."

"I'm hearing from people on the ground that they're not really getting much," Irvin said.

Other legislators questioned how many Qualis employees live in Arkansas.

In response to questions from Sen. Eddie Williams, R-Cabot, Matuszewski said it was fewer than 10 but that he didn't know the exact number.

He said the company also has employees who live outside Arkansas but visit the state to hold seminars for the practices.

Williams said he was concerned that Matuszewski didn't know the number of employees who live in Arkansas.

"If he knows it's less than 10, if there's a number out there it ought to come right off your tongue," he said.

Metro on 09/04/2014

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