Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Amendment to the Agreement with San Mateo Health Commission dba Health Plan of San Mateo
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with San Mateo Health Commission, dba Health Plan of San Mateo, for the administration of the Access and Care for Everyone program, extending the term through September 30, 2024, and increasing the amount by $10,680,750, to an amount not to exceed $93,585,750.
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BACKGROUND:
The County is required to provide health care services to qualifying uninsured residents under Welfare and Institutions Code 17000. The County meets this requirement by offering the Access and Care for Everyone (ACE) program to qualifying uninsured residents whose income is below 200% of Federal Poverty Level.
On July 21, 2015, this Board approved an agreement with the San Mateo Health Commission, dba Health Plan of San Mateo (HPSM), to provide third party administration (TPA) services for the ACE program on behalf of San Mateo Medical Center (SMMC) for the term of April 1, 2015, through March 31, 2018.
The agreement has been amended multiple times since then to include a data usage agreement and to extend the term of the agreement through March 31, 2023, with a corresponding increase in funding.
The competitive bid process was previously waived pursuant to County of San Mateo Administrative Memo B-1, provision IV.B.2, which allows waivers for agreements with other public and government entities.
DISCUSSION:
Under this amendment, HPSM will continue to provide various TPA services to the County related to the ACE program, including, but not limited to, claims processing and data management, outpatient pharmacy benefits, provider relations, and collection of A...
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