Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Stephen Kaplan, Director, Behavioral Health & Recovery Services
Subject: Agreement with Health Plan of San Mateo for Medicare CareAdvantage Program Funding
RECOMMENDATION:
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Adopt a resolution authorizing a revenue agreement with the Health Plan of San Mateo for Medicare CareAdvantage services for the term of January 1, 2017 through December 31, 2019, for an estimated total of $3,000,000
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BACKGROUND:
On May 24, 2005, your Board approved an agreement with the Health Plan of San Mateo (HPSM) whereby Behavioral Health and Recovery Services (BHRS) is reimbursed for the provision of mental health services to clients with Medicare CareAdvantage coverage through the HPSM. That agreement was for the term January 1, 2006 through December 31, 2006, and automatically renews for one-year periods. This funding arrangement has made it possible for clients who have both Medi-Cal and Medicare insurance coverage to avoid having multiple coverage plans, which would have caused considerable hardship for clients in managing their healthcare.
This agreement with the HPSM for mental health services was an essential component of the HPSM proposal to the federal Center for Medicaid and Medicare Services for certification as the Medicare CareAdvantage Plan for San Mateo County.
DISCUSSION:
The HPSM has presented a superseding agreement for Medicare CareAdvantage program services for the term January 1, 2017 through December 31, 2019. This agreement includes necessary revised Medicare administrative requirements. Through this agreement BHRS will continue to provide mental health services to clients with HPSM Medicare CareAdvantage health coverage. BHRS will present to your Board for approval a separate agreement with HPSM, which shall be a revenue agreement for insurance coverage.
The agreement is late due to p...
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