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Health and Human Services Agency (HHSA) recommending the Board approve and authorize the Chair to sign the Extended Letter of Agreement (LOA) with the Health Plan of San Joaquin (HPSJ), which sets forth the terms and rates of reimbursement for authorized medically necessary services to HPSJ members, for the temporary period of January 1, 2024, through June 30, 2024, until a final master agreement is developed, to ensure HHSA and HPSJ can meet implementation deadlines required by the California Department of Health Care Services (DHCS).
FUNDING: N/A
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DISCUSSION / BACKGROUND:
California’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation. Insuring almost one-third of California’s residents, Medi-Cal is a key source of health coverage for low-income children, adults, and people with disabilities. The San Joaquin County Health Commission (Commission), a multi-county commission, contracts with the DHCS to provide a public managed health care plan for people receiving Medi-Cal. Through this managed health care plan, referred to as the HPSJ Local Initiative Two-Plan Medi-Cal Managed Care Plan Model, the Commission has successfully improved health care access for its members and increased reimbursement rates for health care providers.
The HPSJ is a non-profit Health Maintenance Organization (HMO) that has been providing healthcare services to the Central Valley community for over two decades. It is publicly sponsored and collaborates with the Medi-Cal Managed Care Division of the DHCS to deliver healthcare to Medi-Cal members. HPSJ prioritizes primary and preventive care through organized systems of care networks, aiming to provide quality healthcare, improve accessibility, and reduce costs.
Beginning in 2021, the DHCS began expanding the Commission’s public managed health care plan to rural counties, to allow participating counties to have greater local influence and control over their managed care medical system. On August ...
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