REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 26, 2023
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Revenue Provider Services Agreement with Physician Health Network for Ancillary Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Revenue Provider Services Agreement, including non-standard terms, with Physician Health Network for provision of outpatient health care services to designated Medi-Cal Managed Care members, retroactively effective January 1, 2022 through December 31, 2024.
2. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of the Provider Services Agreement 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 will not result in the use of Discretionary General Funding (Net County Cost). This revenue agreement will be utilized to ensure reimbursement to Arrowhead Regional Medical Center (ARMC) from Physician Health Network (PHN) for providing outpatient care to certain Medi-Cal managed care plan members who are assigned to PHN. Adequate appropriation and revenue have been included in the ARMC 2023-24 budget and will be included in the 2024-25 recommended budget.
BACKGROUND INFORMATION
Health plans contract with Independent Practice Associations (IPA), such as PHN, for the provision of care for their Medi-Cal managed care members. The recommended revenue agreement will provide reimbursement from PHN to ARMC for outpatient care services provided by ARMC to Medi-Cal managed care plan members who are assigned to PHN. The agreement is retroactive to January 1, 2022, as Inland Empire Health Plan, one of the health plans contracted with PHN and ARMC, changed its Division of F...
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