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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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San Mateo Medical Center
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DATE:
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June 25, 2007
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BOARD MEETING DATE:
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July 24, 2007
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Sang-ick Chang, Interim Chief Executive Officer
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SUBJECT:
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Resolution Authorizing the Controller to Pay Non-Contract Medical Service Providers
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RECOMMENDATION:
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Adopt a Resolution authorizing the Controller to pay non-contract medical service providers an amount not to exceed ONE MILLION FIVE HUNDRED THOUSAND DOLLARS $1,500,000 for the period July 1, 2007 through June 30, 2009.
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VISION ALIGNMENT:
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Commitment: To Ensure Basic Health and Safety for All.
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Goal(s): Provide residents access to healthcare and preventive care.
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The Resolution contributes to this commitment and goal by providing access to specialty care services.
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Performance Measure(s):
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Measure
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FY 2006-07
Projected
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FY 2007-08
Projected
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Number of patients referred to non-contract providers for specialty care services
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3%
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3%
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BACKGROUND:
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Since 1990, your Board has authorized the Controller to pay non-contract medical providers who provide medical services at other facilities to our MIA patients.
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San Mateo County is responsible for providing necessary medical care to its medically indigent (MI) population. If an MI patient needs services or procedures not offered at San Mateo Medical Center (SMMC), the patient is referred to another off site facility and the expenses must be paid by the County. In a Resolution adopted on January 31, 2006, this Board authorized the Controller to pay up to $1,500,000 to non-contract medical service providers for the period from July 1, 2005 through June 30, 2007.
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DISCUSSION:
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This Resolution will allow the Controller to pay non-contract providers for services provided at Medicare participating fee schedule for San Mateo County Part “B” and on the Medicare Labor Adjusted Ambulatory Surgery Classification (ASC), all other services not found on the Part “B” Medicare Fee Schedule or the ASC will be paid at the Ambulatory Payment Classification (APC) rate. Surgical assists will be paid on service approved for surgical assists at 16% of the approved global surgery services fee.
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All referrals to non-contract providers must be authorized by SMMC Administration, and utilization review is concurrently provided by the Case Management Department at the SMMC.
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TERM AND FISCAL IMPACT:
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The term of the Resolution is July 1, 2007 through June 30, 2009. Payments under this Resolution will not exceed $1,500,000 for the term. Despite a projected increase in patient utilization there is no increase over the last fiscal year Resolution. The Resolution remains the same due to rate reductions. Funds are included in the SMMC FY2007-08 Recommended Budget and will be included in the SMMC FY2008-2009 Proposed Budget.
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