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: Agreement with Moss Adams LLP to Provide Reimbursement Related Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Moss Adams LLP to provide third-party reimbursement services to San Mateo Medical Center for the term November 1, 2018 through October 31, 2021, in an amount not to exceed $900,000.
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BACKGROUND:
All California healthcare facilities are required to report to Medicare, Medi-Cal and the Office of Statewide Health Planning and Development. In addition, County healthcare facilities must submit data for the following supplemental reports: 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 Supplemental payment calculations, and Medi-Cal Waiver (Paragraph #14) reimbursement calculations. San Mateo Medical Center (SMMC) has been contracting for these services with the previous vendor since 1997; the supplemental reports listed above account for approximately 50% of SMMC’s annual net revenue.
DISCUSSION:
A Request for Proposals was completed in July 2018 for reimbursement services. Moss Adams LLP (Moss Adams) was chosen because of their innovative approach, improved reporting accuracy and in-depth insight into hospital reimbursement regulations. In addition, Moss Adams will be working with the SMMC Controller on a new revenue impact study to assess the financial impact of the new Medi-Cal waiver on SMMC’s revenue.
The agreement and Resolution have been reviewed and approved by County Counsel as to form.
The Resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
The agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by maximizing third-party reimbursements for services provided to SMMC patients. It is anticipated that 100% of SMMC’s required reports will be completed and filed to meet federal and state deadlines.
PERFORMANCE MEASURE:
|
Measure |
FY 2017-18 Actual |
FY 2018-19 Projected |
|
Percentage of reports to be completed and filed to meet federal and state deadlines |
100% |
100% |
FISCAL IMPACT:
The term of the agreement is November 1, 2018 through October 31, 2021. The amount of the agreement is not to exceed $900,000 for the three-year term. Funds in the amount of $200,000 are included in the SMMC FY 2018-19 Adopted Budget. Funds in the amount of $300,000 will be included in the SMMC FY 2019-20 Recommended Budget. Similar arrangements will be made for future years.
Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or to those covered by programs that do not meet the full costs of care are covered by the County’s General Fund contribution to SMMC, and are within the existing annual appropriation.