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Meeting Date:
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Category:
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Type:
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Subject:
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11.26 BUSINESS: Service Agreement With Paradigm Healthcare Services, LLC for Medi-Cal Administrative Activities (funded through the Restricted LEA Fund and the Medi-Cal Administrative Activities Fund in an estimated amount of $100,000, not the General Fund) |
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Strategic Plan:
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Enclosure:
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File Attachment:
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Summary:
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The Perris Union High School District would like to retain Paradigm Healthcare Services, LLC (Paradigm) to assist in claiming revenue for Local Education Agency (LEA) and Medi-Cal Administrative Activities (MAA) related services for the 2025-26 school year. Paradigm services include the determination of Medi-Cal eligibility, preparation of the annual Cost and Reimbursement Comparison Schedule (CRCS), development and submission of the MAA Operational Plan to the Lead County or Regional Agency as determined by District membership, and assistance with calculation of transportation direct charge rates of all students receiving non-healthcare transportation and have transportation designated in their Individual Education Program or Individual Health and Support Plans.
The total amount for this Agreement is estimated to be $100,000 but is ultimately based on the number of claims filed. Paradigm’s fees for LEA Billing Claims Management Services in any will be capped according to the dollar value of the District’s Interim Approved Claims. Notwithstanding any other provision, the total fees payable to Paradigm based on Interim Approved Claims during any Fiscal Year will not exceed 7% of the dollar value of Interim Approved Claims. The fee for MAA Invoice Preparation & Submission Services each fiscal quarter during the Term of the Agreement will be an amount equal to $45 multiplied by the sum of: (i) the number of time survey participants claimed on District’s MAA Invoice for that fiscal quarter, and (ii) the number of individuals identified as a direct charge in District’s MAA Invoice for that fiscal quarter.
The term of this Agreement shall be from July 1, 2025, through June 30, 2026. |
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Funding:
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The cost for this item will be included in the 2025-26 operating budget funded through the Restricted LEA Fund and the Medi-Cal Administrative Activities Fund, not the General Fund. |
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Recommendation
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It is recommended that the Board of Trustees approve the Service Agreement with Paradigm Healthcare Services, LLC for Medi-Cal administrative activities. |
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Approvals:
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Recommended By: |
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Signed By: |
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Mimi Capistrano - Director - Fiscal Services |
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Signed By: |
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Sylvia Hinojosa - Director - Purchasing |
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Signed By: |
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Candace Reines - Deputy Superintendent |
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Signed By: |
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Dr. Jose Luis Araux - Superintendent |
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