IRS Form 990-PF for 2009 - Blue Shield of California Foundation

California Physicians' Service Fdn
(dba Blue Shield of California Fdn)
FEIN: 94-2822302
Attachment E
Blue Shield of California Foundation
FEIN 94-2822302
ATTACHMENT TO 2009 FORM 990-PF
RETURN OF PRIVATE FOUNDATION
STATEMENT REQUIRED BY REG. §53.4945-5(d)
INFORMATION WITH RESPECT TO EXPENDITURE RESPONSIBILITY GRANTS
(1) Grantee:
Center for Medical Technology Policy
524 Second Street, 2nd Floor
San Francisco, CA 94107
(2) Grant Amount:
$325,000
Date of Grant:
1/1/2008
(3) Purpose:
To plan and launch the implementation of two prospective comparative effectiveness
(CE) pilot studies and to develop a methodology, in conjunction with the National
Committee for Quality Assurance (NCQA), for CE performance measurement
development. Additionally, the project will refine strategies for engaging consumers and
patients in CE research.
(4) Total Paid:
$162,500 paid on 12/28/2007
$162,500 paid on 7/16/2008
TOTAL $325,000
Amount of Grant Spent by Grantee:
$325,000
(5) Diversion:
To the knowledge of the Foundation, and based on the report furnished by the grantee,
no grant funds have been diverted from the purpose of the grant.
(6) Date of Report(s) Received from Grantee:
7/1/2008
5/1/2009
2/1/2010 (FINAL)
(7) Verification
Blue Shield of California Foundation reviewed the grant reports received but did not
undertake any verification of the grantee's reports as there has not been any reason to
doubt their accuracy or reliability (Reg. 53.4945-5(c)).
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