For City Council Meeting [April 10, 2018]
TO: Honorable Mayor and City Council
APPROVAL: Robb R. Steel, Interim City Administrator
FROM: Sean Grayson, Fire Chief
Title
Request City Council to Approve the Amended Agreement between the City and Inland Molina Health Care of California (MHCC) to Identify Certain Health Care Services Provided by the City to Medi-Cal Managed Care Beneficiaries.
Body
BACKGROUND:
The City's costs associated with delivering Emergency Medical Services (EMS) and ambulance transport are offset through fees charged to the users of these services. Due to restrictions on certain publicly provided insurance plans, the City cannot collect the total amount billed for these services from individual policyholders in these plans. However, the City has an opportunity to recover some of these unreimbursed costs from the State by entering into a Rate Range Intergovernmental Transfer (IGT) program with the California Department of Healthcare Services (DHCS).
The City has current agreements with two with the state-designated Medi-Cal Managed Care insurance carriers in San Bernardino County as participants in the IGT program. These include Inland Empire Health Plan (IEHP) and Molina Healthcare of California (MHCC). These agreements memorialize a relationship that currently exists between the parties, which is the City's provision of services to the carrier's beneficiaries, and the carrier's obligation to pay the City for the services up to the allowable rate. The agreements do not include any additional services or additional exchange of funds.
The agreement with MHCC has been proposed for amendment. Acceptance of the amended agreement is required for the City's continued participation in the IGT program with Molina participants.
ANALYSIS/DISCUSSION:
The City of Rialto provides pre-hospital healthcare services to its residents and visitors through the Fire Department's EMS and ambulance transport system. The City charges a fee for thes...
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