Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, Health System
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Alan McBride to Provide Reimbursement Management Consulting Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Alan McBride to provide Reimbursement Management services for the term of October 1, 2018 through September 30, 2021, in an amount not to exceed $850,000.
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BACKGROUND:
As a public hospital, San Mateo Medical Center (SMMC) serves a broad mix of patients and the federal and State regulations governing reimbursement for medical services provided by SMMC are complex. Approximately 60 percent of SMMC's annual revenue comes from federal and State reimbursement programs, such as Medicaid's Disproportionate Share Hospital program, the California Department of Health Care Services' Medicaid 1115 Waiver, Medi-Cal, Medicare, and other programs. In addition, the recently-enacted Medicaid Managed Care Rule resulted in new funding programs.
Administering hospital reimbursement functions for these programs requires a high level of knowledge and experience, due to the programs' complexity and documentation requirements. SMMC requires support from a consultant who can analyze the hospital's participation in these various programs and ensure that SMMC submits accurate cost reports and other requested documentation to support the ongoing reimbursement. Alan McBride has been providing reimbursement-related services at SMMC on a contracted basis since September 2015.
DISCUSSION:
Mr. McBride has an extensive background in this subject area, including experience working as a reimbursement manager for the County of Alameda and previously serving as Chief Financial Officer for multiple hospitals. In addition, SMMC anticipates a change in its current Centers for Medicare & Medicaid ...
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