REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 26, 2024
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Agreement with Inland Empire Health Plan for Reimbursement Rates
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 11 to Hospital Per Diem Agreement No. 20-887 with Inland Empire Health Plan to increase Arrowhead Regional Medical Center’s reimbursement rates and update certain provisions relating to Inland Empire Health Plan’s Covered California Network, retroactively effective January 1, 2023, and no changes to the total term of October 1, 2020 through December 31, 2024.
2. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of Amendment No. 11 to Hospital Per Diem Agreement No. 20-887, 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
Operate in a Fiscally-Responsible and Business-Like Manner
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). Expenditures for medical services provided to Inland Empire Health Plan (IEHP) members are funded through reimbursements from IEHP. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2023-24 budget and will be included in 2024-25 recommended budget.
BACKGROUND INFORMATION
This recommended amendment will provide an increase in the reimbursement rates to the County for medical services provided at ARMC to IEHP members. ARMC has been a designated hospital provider within IEHP’s network since 2008, providing in-patient services, emergency services, and other outpatient care services. The amendment will also update the citation references relating to the contract between IEHP and the State of California.
Approval of this amendment will be retroactively effective to January 1, 2023, resulting in additional revenue to ARMC based on increase of certain reimbursement rates. Discussions regarding new reimbursement rates began in December 2023 and concluded the end of January 2024. This item is being retroactively presented at this time as this is the first available date following the required operational, fiscal, and legal reviews.
On September 15, 2020 (Item No. 15), the Board of Supervisors (Board) approved Agreement No. 20-887 with IEHP to provide reimbursement for medical services rendered by ARMC to IEHP members, for the period of October 1, 2020 through September 30, 2023. The Board has since approved 10 amendments to Agreement No. 20-887 to allow ARMC to receive supplemental payments for Medi-Cal managed care capitation rate range increases during State established claim periods, update program eligibility, amend compensation and reimbursement rates, and extend the term of the agreement, as follows:
|
Amendment No. |
Board Date |
Item No. |
|
1 |
September 29, 2020 |
15 |
|
2 |
December 15, 2020 |
9 |
|
3 |
May 18, 2021 |
10 |
|
4 |
August 10, 2021 |
7 |
|
5 |
October 26, 2021 |
12 |
|
6 |
December 7, 2021 |
9 |
|
7 |
March 15, 2022 |
11 |
|
8 |
February 7, 2023 |
9 |
|
9 |
March 28, 2023 |
13 |
|
10 |
February 27, 2024 |
8 |
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 the 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 March 14, 2024; Finance (Chen Wu, Finance and Budget Officer, 580-3165) on March 1, 2024; Finance (Jenny Yang, Administrative Analyst, 387-4884) on March 5, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on March 5, 2024.