RESOLUTION NO. _____________

BOARD OF SUPERVISORS, COUNTY OF SAN MATEO, STATE OF CALIFORNIA

* * * * * *

RESOLUTION AUTHORIZING THE CONTROLLER TO PAY NON-CONTRACT PHYSICIANS FOR EMERGENCY, EMERGENT AND NON-CONTRACTED SERVICES AT SAN MATEO MEDICAL CENTER AND PHYSICIANS AT NON-CONTRACTED HOSPITAL FACILITIES IN AN AMOUNT NOT TO EXCEED $150,000 FOR THE TERM JULY 1, 2011 THROUGH JUNE 30, 2013

______________________________________________________________

RESOLVED, by the Board of Supervisors of the County of San Mateo, State of California, that

WHEREAS, the San Mateo Medical Center (SMMC) must occasionally secure specialty medical care from physicians with whom it does not contract in order to provide needed services to patients for whom the County is responsible when contracted or staff physicians are not available; and

WHEREAS, it is sometimes necessary to send medically indigent patients to non-County facilities when the necessary procedure or surgery is not available at SMMC; and

WHEREAS, this Board has determined that the continuation of funding for such services provided by non-contract physicians is warranted.

NOW, THEREFORE, IT IS HEREBY DETERMINED AND ORDERED that the Controller is authorized to pay claims made by non-contract physicians that are submitted by the Chief of the Health System or designee for and on behalf of the County of San Mateo in an aggregate amount not to exceed $150,000 for the term July 1, 2011 through June 30, 2013.

BE IT FURTHER RESOLVED that the Controller is hereby authorized and directed to execute payments for such authorized medical services to specialists, including but not limited, to neurosurgeons, gastroenterologist, pediatric on-call coverage and dental surgeons, who provide professional specialty services when no other medical services coverage is available. In the case of multiple procedures, the first procedure will be paid at 100% of the prevailing Medicare participating fee schedule for San Mateo County for all Part “B” services that can be reimbursed pursuant to the Center for Medicare and Medicaid Services (CMS) guidelines or the Medicare Labor Adjusted Ambulatory Surgery Classification (ASC), and all services not found on the Part “B” Medicare Fee Schedule or the ASC that are considered reimbursable pursuant to CMS guidelines will be paid under the Ambulatory Payment Classification (APC) rate. All additional procedures will be paid at 50% of the Medicare Allowable reimbursement rate. Surgical assistant services that are a covered benefit under CMS guidelines will be paid at 20% of the approved Medicare global surgery service fee.

* * * * * *