Title
Authorize the Chief Executive Officer of Natividad Medical Center (NMC) to execute the Central California Alliance for Health (CCAH) Eighth (8th) Amendment to the Referral Physician Services Agreement ("Agreement") increasing payment rates for specialist services for CCAH Medi-Cal providers.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
Authorize the Chief Executive Officer of Natividad Medical Center (NMC) to execute the Central California Alliance for Health (CCAH) Eighth (8th) Amendment to the Referral Physician Services Agreement ("Agreement") increasing payment rates for specialist services for CCAH Medi-Cal providers.
SUMMARY/DISCUSSION:
The Central California Alliance for Health (CCAH) is the Medi-Cal Managed Care Commission for Santa Cruz-Monterey-Merced counties. NMC provides specialty care physician services to CCAH members. The County of Monterey, on behalf of NMC, entered into a Referral Physician Agreement with CCAH with an original term of January 1, 2011 through December 31, 2011. Since then, the Agreement has been renewed automatically for successive one-year terms, subject to three termination provisions (immediate termination, termination without cause, termination with cause).
The amendment is a change in the reimbursement formula that will increase payment for specialty physician services.
CCAH requests that the County of Monterey sign the agreement prior to CCAH signing.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Amendment No. 8 as to legal form and risk provisions, and the Auditor-Controller has reviewed and approved as to payment provisions. The Amendment No. 8 has also been reviewed and approved by NMC's Finance Committee on 05/26/16 and by its Board of Trustees on 06/03/16.
FINANCING:
There is no impact to the General Fund.
Prepared by: Nancy Majewski, Managed Care Operations Manager, 783-2385
Approved by: Gary R. Gray, DO, Chief Executiv...
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