File #: A 19-008    Name: Authority to Sign Government Payer Agreements/Amendments
Type: BoS Agreement Status: Passed - Natividad Medical Center
File created: 2/6/2019 In control: Board of Supervisors
On agenda: 2/26/2019 Final action: 2/26/2019
Title: Authorize the Chief Executive Officer of Natividad Medical Center ("NMC") until June 30, 2024 to execute agreements/amendments with government payers of healthcare services, including agreements/amendments containing non-standard risk provisions, for the purpose of adding NMC as an in-network provider of healthcare services for both hospital and professional services and for establishing reimbursement methodologies used in healthcare payments, subject to County Counsel and Auditor-Controller approval.
Attachments: 1. Board Report, 2. 34. Completed Board Order
Title
Authorize the Chief Executive Officer of Natividad Medical Center ("NMC") until June 30, 2024 to execute agreements/amendments with government payers of healthcare services, including agreements/amendments containing non-standard risk provisions, for the purpose of adding NMC as an in-network provider of healthcare services for both hospital and professional services and for establishing reimbursement methodologies used in healthcare payments, subject to County Counsel and Auditor-Controller approval.

Report
RECOMMENDATION:

It is recommended the Board of Supervisors:

Authorize the Chief Executive Officer of Natividad Medical Center ("NMC") until June 30, 2024 to execute agreements/amendments with government payers of healthcare services, including agreements/amendments containing non-standard risk provisions, for the purpose of adding NMC as an in-network provider of healthcare services for both hospital and professional services and for establishing reimbursement methodologies used in healthcare payments, subject to County Counsel and Auditor-Controller approval.

SUMMARY/DISCUSSION:

The County of Monterey, on behalf of Natividad Medical Center ("NMC"), has contracts with government payers, including Santa Clara County, Santa Cruz County and Central California Alliance for Health. Some of the payer agreements have been in place for over 20 years.
The purpose of a payer agreement is to allow NMC to be an in-network provider to provide inpatient and outpatient services to the government program members and/or enrollees. As government entities are responsible for constituents, the entities in turn request agreements or modifications to their existing agreements with hospitals and providers.
In many situations, a government entity would want to have an agreement in place in a very short timeframe in order to provide the appropriate network of hospitals and physicians for patients needing care. Having the network in place is important for a gover...

Click here for full text