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Mental Health Department recommending the Board approve and authorize said Department to publish updated rates for Medi-Cal eligible services.
RECOMMENDED ACTION: Approve.
FUNDING: State MediCal Revenues.
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BUDGET SUMMARY: |
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Fiscal Impact/Change to Net County Cost: There is no cost associated with this rate change however the new rates will allow the department to maximize monthly MediCal revenues from the State. MediCal revenues for the department are approximately $7 million per year.
Background: Each year the California Department of Mental Health provides a revised Short-Doyle/Medi-Cal Maximum Reimbursement Rate Allowance (SMA) per Welfare & Institution Code Section 5720(a) and (b) that establishes the maximum amount of reimbursement from the State for services provided by County Mental health programs to Medi-Cal eligible individuals. Each County has the ability to establish and adjust its own published rates at any time, but those rates may not exceed the current State SMA rate. Reimbursement from the State to the County is made based on the number of services provided multiplied by the County's published rate. At the end of each fiscal year, a cost report is completed that results in an actual rate for services provided. The State then settles with each County at the lower of the actual or published rate.
Reason for Recommendation: The Department's goal in revising its published rates is to maximize monthly Medi-Cal reimbursement for the State share of the actual costs of providing services. The proposed rates are based on FY 2006-07 actual costs resulting from the most recently completed Cost Report with an increase for anticipated costs for services in FY 2008-09. The recommended rates are still below current revised SMA rate from the State (see attached chart).
Action to be taken following Board approval: Upon Board approval, the Department will publish the proposed rates and update the billing system accordingly.
Contact: John Bachman, Mental Health