HomeMy WebLinkAboutMINUTES - 06251985 - 1.66 TO; BOARD OF SUPERVISORS �-
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• FROM: Mark Finucane, Health Services Director (�^ }
By: Elizabeth A. Spooner, Contracts Administrator Costa
DATE: June 13, 1985 County
SUBJECT: Approval of Contra Costa Health Plan Medicare Contract #29-608-1 with the
Secretary of the U. S. Department of Health and Human Services
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
Approve and authorize the Chairwoman to execute on behalf of the County, Contra
Costa Health Plan Medicare Contract #29-608-1 with the Secretary of the U. S.-
Department
:Department of Health and Human Services effective July 1, 1985 through June 30,
1986, and automatically renewed for successive periods of one year unless ter-
minated by written notice of intention not to renew at least 90 days before the end
of the current period.
II. FINANCIAL IMPACT:
The current Medicare contract covers 649 Health Plan members and is budgeted to
cover 657 members in Fiscal Year 1985-86. As in the current agreement, Contract
#29-608-1 is a cost reimbursement .agreement and will produce $639,720 in premium
revenue and approximately $225,000 in annual cost settlement for a total annual
revenue of approximately $865,000. In addition, for those members crossed over to
Medi-Cal membership, the State of California pays the County annual revenue of
$591,750 so that the total revenue is $1,456,750. Cost of this group of .members
depends on the use of services by Medicare-eligible members and the Health Services
Department costs.
Terms of the contract provide for reimbursement to Contra Costa Health Plan for the
cost of Medicare-covered services. State-provided rates for Medi-Cal and Medicare
eligibles in the Plan, and Board-approved premiums for private Medicare members,
cover benefits and services which exceed the Medicare level.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On October 26, 1976 the Board of Supervisors approved Contract #29-608 with the
U. S. Secretary of Health, Education and Welfare for prepaid health services by the
County for Medicare-eligible persons. Contract #29-608 was effective December 1,
1976 through June 30, 1978, and automatically renewed for successive periods of one
year.
The Department of Health and Human Services has developed a new standard contract
for health insurance benefits for the aged and disabled which supersedes Contract
#29-608. In order to maintain membership of persons covered under the current
agreement, Contract #29-608-1 must be signed and returned to the Department of
Health and Human Services by June 30, 1985. Maintenance of this Medicare contract
is necessary to accomplish the marketing plan of enrolling additional Medicare-
eligible persons.
This document has been approved by County Counsel.
The Board Chairwoman should sign four copies of the contract, three of which should
then be returned to the Contracts and Grants Unit for submission to the Department
of Health and Human Services.
CONTINUED ON ATTACHMENT: X YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMME TION OF BOA D COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
X_ UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
ORIG: Health Services (Contracts)
CC: County Administrator ATTESTED _ �n1
Auditor-Controller PHILf�BATCHELOR, CLERK OF THE BOARD OF
Contractor SUPERVISORS AND COUNTY ADMINISTRATOR,,,
M382/7-88 BY ! 1"LeDEPUTY
Board Order
Contract #29-608-1
Page 2
IV. CONSEQUENCES of NEGATIVE ACTION:
Failure to approve this contract will result in the following: a) immediate. loss
of 657 Health Plan members as of July 1, 1985, b) loss of ability of Health Plan
to enroll additional Medicare eligible members, and c) loss of $865,000 revenue
from Medicare enrolled members with the possibility of an additional loss of
$591,750 if these members also disenroll from the Medi-Cal contract group.