COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

June 13, 2003

BOARD MEETING DATE:

July 15, 2003

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer

SUBJECT:

Resolution Authorizing the Controller to Pay Non-Contract Physicians Who Provide Medical Services for San Mateo Medical Center.

Recommendation

Adopt a resolution authorizing the Controller to pay non-contract physicians who provide medical services for San Mateo Medical Center.

Background

From time-to-time it is necessary to augment the county contracted physicians with non-contract physicians because there is not sufficient coverage for specialty care. Examples of shortages include, but are not limited to, pediatric on-call coverage, gastroenterology, neurosurgery and dental surgery. These specialists provide emergency backup when no other medical coverage is available.

Discussion

This resolution will authorize the Controller to pay all on-call specialists, including gastroenterologists, neurosurgeons, and dental surgeons who provide emergency backup when no other medical coverage is available, at 60% of their billed inpatient charges and 50% of their billed outpatient charges or the prevailing Medicare Fee Schedule for San Mateo County. For surgical assists payment is to be made at prevailing Medicare fee schedule for assists which in 2002 equals 15% of the Medicare allowable for the surgery itself.

If on-call specialists are not available, patients needing these services will be required to be transferred to other providers at a considerably higher county expense. All services are pre-approved through the Case Management unit of the Hospital.

Vision Alignment

This agreement keeps the commitment to Ensure Basic Health and Safety for All and goal number 5: Provide residents access to healthcare and preventive care. The agreement contributes to this commitment and goal by continuing to provide healthcare services to county patients.

Fiscal Impact

The term is July 1, 2003 through June 30, 2005. Payments under this resolution will not exceed $280,000 for the term. Funds are included in the San Mateo Medical Center FY2003-04 Recommended Budget and will be included in the budget request for FY2004-05.