|REVISED April 25, 2017 - Regular Meeting|
Agenda Item #42
Agreement for Hospital Services
Briefing Provided Upon Request
Contact and/or Presenter Information
Cheri Coryea, Director-Neighborhood Services Dept., ext 3468
Joshua Barnett, Health Care Services Manager, ext 3978
Authorization for the County Administrator to execute the FY17 funding agreement with Manatee Memorial Hospital for the provision of health care services to qualified uninsured residents of Manatee County in an amount not to exceed $3,021,586, for the time period October 1, 2016 - September 30, 2017.
Florida Statute 125
- Traditionally, hospitals in Manatee County have entered into agreements with the County to provide health care to low income uninsured residents with eligible conditions that present at the hospital emergency rooms.
- In 2015, Manatee County instituted a requirement of participation in a Health Information Exchange (HIE) for hospitals that would allow the sharing of health information to avoid duplication or unnecessary services and track frequency visits for clients.
- Manatee Memorial Hospital was the only hospital that participated in this requirement.
- As Manatee Memorial Hospital provides the majority of health care services to persons that meet the County program, we are seeking to continue our relationship with the hospital for uninsured patient coverage.
- Staff recommends the allocation of $3,021,586. This recommendation subtracts the Low Income Pool (LIP) funds that the County has committed to the Agency for Health Care Administration (AHCA) for 2017 from last years ($3,526,586) Manatee Memorial Hospital agreement. This represents a reduction in FY17 to Manatee Memorial of $505,000.
- Services provided must be medically necessary as defined by AHCA and outlined in Attachment A Section 2(f) of the agreements, including inpatient services that cannot be performed more economically on an outpatient basis or in another type of facility.
- Required participation in the exchange of healthcare information through HIE (Health Information Exchange) Networks.
- Patient eligibility determined using county-owned IHS software and at numerous points of entry - examples: physicians offices, hospital emergency departments, We Care, Turning Points, and the Neighborhood Services Department-Community Services Division.
- Participation requirements - income at or below 200% of the Federal Poverty Level (FPL); proof of county residency.
- Requires data submission
- Providers will:
- Enroll all clients in a Healthcare Information Exchange (HIE) as chosen and specified by the County as permitted by HIPAA legislation
- Ensure client data entered into the HIE is current for each client contact and update data as needed and permitted by HIPAA legislation
- Participate in all administrative or clinical community meetings as required by the County, help to identify gaps in Manatee County Healthcare, and provide information on industry best practices as needed
- Submit any additional documentation or reports as requested
- Actively collaborate with the Manatee County Healthcare Advisory Board as requested
- Rate of reimbursement is the Ratio of Cost to Charges (RCC) percentage that is set with Centers for Medicare & Medicaid Services (CMS), as shown in the most recent Medicare cost report
County Attorney Review
Not Reviewed (Utilizes exact document or procedure approved within the last 18 months)
Explanation of Other
Instructions to Board Records
Send any related documents to email@example.com.
Cost and Funds Source Account Number and Name
$3,021,586 - General Fund for Health Care
Amount and Frequency of Recurring Costs
To be determined annually based on need
Attachment: MMH Agreement FY17 - 04.24.17.pdf
Attachment: 2016 federal poverty level.pdf