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: Rate Increases in the San Mateo Medical Center Charge Description Master Fee Schedule
RECOMMENDATION:
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Adopt a resolution authorizing:
A) An increase in the daily room rates for inpatient services at SMMC; and
B) An increase in the evaluation and management rates for the Emergency Department at SMMC; and
C) The Chief of San Mateo County Health or her designee to implement increases to the Charge Description Master up to six percent annually; and
D) The Chief of San Mateo County Health or her designee to negotiate discounts with non-federal, non-state, non-contracted third-party health care insurance carriers and self-pay individuals.
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BACKGROUND:
The Charge Description Master (CDM) is a fee schedule that contains the prices of all services, supplies, and procedures for medical services provided at San Mateo Medical Center (SMMC). Pursuant to government regulations and SMMC's commitment to price transparency, SMMC posts its CDM on its website and with the California Office of Statewide Health Planning and Development.
SMMC reviews its CDM periodically to ensure that charges for services, supplies, and procedures are reasonably related to both the cost of the service and meeting the community's health care needs.
SMMC charges the same price to all patients regardless of their insurance program or coverage. The charges, however, do not reflect the actual amounts SMMC receives, because each insurance program (e.g. Medicare, Medi-Cal, Blue Cross, etc.) has established or negotiated rates they will pay for services.
SMMC accepts all insurance. In general, if a patient has commercial insurance coverage and receives care at SMMC, the hospital will work with the payor to negotiate the rate to b...
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