REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 10, 2021
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Hospital Per Diem Agreement with Inland Empire Health Plan and Health Access for Supplemental Reimbursement
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 4 to Hospital Per Diem Agreement (Agreement No. 20-887), with Inland Empire Health Plan and Health Access to add compensation rates for additional services, retroactively effective July 1, 2021.
2. Direct the Clerk of the Board to maintain confidentiality of Amendment No. 4 pursuant to Health and Safety Code Section 1457(c)(1).
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item with Inland Empire Health Plan and Health Access (collectively referred to as “IEHP”) will not result in the use of Discretionary General Funding (Net County Cost). The amendment provides supplemental revenue to Arrowhead Regional Medical Center (ARMC) for additional medical services provided by ARMC to IEHP members. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2021-22 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Approval of this item will allow IEHP to compensate ARMC for the treatment of IEHP members and adds Breathmobile services to the list of medical services eligible for reimbursement. Breathmobile services are the result of a collaboration between various school districts and ARMC offering onsite asthma treatments to students.
On September 15, 2020 (Item No. 15), the Board of Supervisors (Board) approved a Hospital Per Diem Agreement (Agreement No. 20-887) with IEHP to provide reimbursements for medical services provided at ARMC for certain Medi-Cal and Medicare member patients.
On September 29, 2020 (Item No. 15), the Board approved Amendment No. 1 to Agreement No. 20-887 to render ARMC eligible to receive supplemental payments from IEHP as a result of Medi-Cal managed care capitation rate range increases.
On December 15, 2020 (Item No. 9), the Board approved Amendment No. 2 to Agreement No. 20-887 to terminate the Centers of Excellence Specialty Pharmacy Program for treatment of Hepatitis B and C and to amend the submission deadline for patient claims from 120 days to 365 days.
On May 18, 2021 (Item No. 10), the Board approved Amendment No. 3 to Agreement No. 20-887 for a one-time supplemental payment to the County to compensate for the volume of COVID-19 IEHP member bed days experienced by ARMC in 2020.
IEHP agreed to provide compensation using the new rates effective July 1, 2021. However, Amendment No. 4 from IEHP detailing the compensation rates for additional services was not received until the second week of July. The item is being presented at this time as this is the first available Board date following the required operational, fiscal, and legal reviews. Approval at this time will have no impact on the provision of services.
Pursuant to Health and Safety Code section 1457(c)(1) specific terms related to the rates of payment for health care services are not immediately subject to laws related to public records; therefore, the Clerk of the Board is directed to maintain confidentiality of this Amendment.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387- 5455) on July 19, 2021; ARMC Finance (Chen Wu, Finance and Budget Officer, 580- 6150) on June 20, 2021; Finance (Amanda Trussell, Principal Administrative Analyst, 387-5423) on July 23, 2021; and County Finance and Administration (Matthew Erickson, County Chief Financial Officer, 387-5423) on July 23, 2021.