REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
October 26, 2021
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Hospital Per Diem Agreement with Inland Empire Health Plan and IEHP Health Access
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 5 to Hospital Per Diem Agreement No. 20-887 with Inland Empire Health Plan and IEHP Health Access, to increase Arrowhead Regional Medical Center’s reimbursement rate for COVID-19 related hospital stays, retroactively effective June 1, 2021 through October 31, 2021.
2. Direct the Clerk of the Board to maintain confidentiality of Amendment No. 5 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 IEHP 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 COVID-19 related hospital stays by IEHP members. Adequate appropriation and revenue have been included in the ARMC 2021-22 budget.
BACKGROUND INFORMATION
Approval of this item will allow IEHP to provide increased reimbursements to ARMC for the additional hospital costs associated with treating COVID-19 patients and related protocols for the period of June 1, 2021 to October 31, 2021.
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 IEHP member patients, from October 1, 2020 through September 30, 2023.
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.
On August 10, 2021 (Item No. 7), the Board approved Amendment No. 4 to Agreement No. 20-887 to add compensation rates for additional services, retroactively effective July 1, 2021.
This amendment supports the County goals and objectives as the reimbursements support the hospital in operating in a fiscally-responsible and business-like manner.
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 September 17, 2021; ARMC Finance (Chen Wu, Finance and Budget Officer, 580- 6150) on September 22, 2021; Finance (Yael Verduzco, Administrative Analyst, 387-5285) on October 7, 2021; and County Finance and Administration (Matthew Erickson, County Chief Financial Officer, 387-5423) on October 11, 2021.