REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 10, 2025
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Hospital Per Diem Agreement with Inland Empire Health Plan for Reimbursements of Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 14 to Hospital Per Diem Agreement No. 20-887 with Inland Empire Health Plan, to provide clarity regarding the compensation language in the existing agreement to more accurately align with the reimbursement methodologies, with no change to the contract term of October 1, 2020 through December 31, 2026.
2. Direct the Clerk of the Board to maintain confidentiality of the Amendment pursuant to Health and Safety Code Section 1457 (c)(1).
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 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 incurred for the provision of Hospital Per Diem Agreement No. 20-887 (Agreement) are funded through reimbursements by Inland Empire Health Plan (IEHP). Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2024-25 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Approval of Amendment No. 14 will continue to allow ARMC to be reimbursed for all patient care services provided to IEHP members. The amendment will modify our agreement with IEHP Covered California clients from Prevailing Medicare rates to Original Medicare rates. This will ensure proper reimbursement to the County for medical services provided at ARMC to certain IEHP Medi-Cal and Medicare participants. IEHP is a public initiative managed care health plan that provides services to residents eligible for benefits of managed care Medi-Cal and Medicare. Amendment will be applied retroactively, effective Jan. 1, 2024 and there will be no changes applied specific to outpatient services under the Covered California line of business. ARMC received notice from IEHP on correction of language on February 12, 2025.
On December, 17, 2024 (Item No. 23), the Board of Supervisors (Board) approved Amendment No. 13 to Hospital Per Diem Agreement No. 20-887 with Inland Empire Health Plan, to extend the term by two-years, funded through reimbursements, for a total contract term of October 1, 2020 through December 31, 2026.
On September 15, 2020 (Item No. 15), the Board of Supervisors (Board) approved the Agreement with IEHP to provide reimbursement for medical services rendered to IEHP members, for the period of October 1, 2020, through September 30, 2023. The Board has since approved 12 amendments to the Agreement 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, through December 31, 2024.
Pursuant to Health and Safety Code Section 1457(c)(1), records that reflect 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, Supervising Deputy County Counsel, 387-5455) on May 13, 2025; ARMC Finance (Chen Wu, Budget and Finance Officer, 580-3165) on May 16, 2025; Finance (Jenny Yang, Administrative Analyst, 387-4884) on May 20, 2025; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on May 20, 2025.