COUNTY OF SAN MATEO | |||||||
Health System | |||||||
DATE: |
February 18, 2009 | ||||||
BOARD MEETING DATE: |
March 31, 2009 | ||||||
SPECIAL NOTICE/HEARING: |
None | ||||||
VOTE REQUIRED: |
Majority | ||||||
TO: |
Honorable Board of Supervisors | ||||||
FROM: |
Jean S. Fraser, Chief, Health System | ||||||
SUBJECT: |
Agreement with Toyon Associates, Inc. | ||||||
RECOMMENDATION: | |||||||
Adopt a Resolution: | |||||||
1. |
Waiving the Request for Proposals process; and | ||||||
2. |
Authorizing the President of the Board to execute an Agreement with Toyon Associates, Inc. to provide third-party reimbursement services to San Mateo Medical Center for the term March 1, 2009 through June 30, 2012, in an amount not to exceed $708,940; and | ||||||
3. |
Authorizing the Chief of the Health System or designee to execute contract amendments which modify the County’s maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions. | ||||||
VISION ALIGNMENT: | |||||||
Commitment: Responsive, effective and collaborative government. | |||||||
The Agreement contributes to this commitment and goal by ensuring that San Mateo Medical Center collects revenues, files cost reports and facilitates audits in a timely manner. | |||||||
Performance Measure |
|||||||
Measure |
FY 2007-08 |
FY 2008-09 | |||||
Timely preparation and submission of Regulatory Reports |
95% |
98% | |||||
BACKGROUND: | |||||||
Toyon Associates, Inc. (Toyon) has been providing third party reimbursement consulting services to San Mateo Medical Center (SMMC) for approximately eight years. Toyon has extensive knowledge of SMMC’s operations and challenges. Toyon’s thorough knowledge of Medicare and Medi-Cal regulatory matters, combined with their in-depth understanding of SMMC, allows for high quality, efficient services, enabling SMMC to optimize its reimbursements and maintain compliance with reporting requirements. | |||||||
DISCUSSION: | |||||||
All healthcare facilities are required to report to Medicare, Medi-Cal and the Office of Statewide Health Planning and Development (OSHPD). In addition, County healthcare facilities must also submit data for: Federally Qualified Health Care (FQHC) reporting (including change of scope calculations and the annual FQHC payment reconciliation), SB 1732 and AB 915 calculations, Skilled Nursing Facilities (SNF) Supplemental payment calculations, Medi-Cal Waiver (Paragraph #14) and Access of Care for Everyone (ACE) reimbursement calculations. These additional County facility supplemental reports account for approximately 30% of SMMC’s annual net revenue. | |||||||
FISCAL IMPACT: | |||||||
The term of this Agreement is March 1, 2009 through June 30, 2012. The maximum amount payable will not exceed $708,940. Funds in the amount of $70,000 are included in the SMMC FY 2008-09 Adopted Budget and the remaining $638,940 will be included in future Recommended Budgets. The Net County Cost is $708,940. |