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Home My WebLink AboutSS3 - Medi-Cal Managed Care Rate Transfer Program - PowerPointProgram Overview Medi -Cal Managed Care Rate Range Intergovernmental Transfer (IGT) City Council Study Session Tuesday, June 14,2o16 Scott Poster, Fire Chief Angela Crespi, Administrative Manager June 14, 2016 Item No. SS3 Program Purpose/Benefits • Enables the states to utilize local dollars as matching funds. • Allows California's Medi -Cal managed care plans to partner with local units of government to access additional federal Medicaid dollars to support uncompensated care and the provision of health care services. • Provides an opportunity for local service providers to recover a portion of their previously unreimbursed costs. Why Participate? Medi -Cal Payment - Considered payment in full In FY2014-15 (last fiscal year) • Medi -Cal represented 18% of total emergency ambulance transport patients • Medi -Cal Managed Care is on the Rise • Average Cost/Transport $i,447 0 Average Payment /Transport $129.o8 (g%) Medi -Cal Services to CalOptima Patients FY2014-15 390 Ambulance Transports = Total Service Costs $564,330 $50,157 (9%) $514,173 (91%) Payments Received Unreimbursed Program Steps and Cycle City of Newport Beach (Local Funds) -"qqftftft�... Transfer of Local Funds & z0% State Administrative Fee CalOptima Returns Original Funds + 50% of Leveraged Funds 5 State DHCS State Draws Down Federal Match Federal Government CalOptima 4 CalOptima Receives Increased Capitation Payment FY 2014-15 Participation Funding IGT Transfer to DHCS Administrative Fee to DHCS State Match Federal Match Increased Capitation from DHCS to CalOptima CalOptima Pays MMCS Tax 50% of Unreimbursed Costs 20% of IGT Transfer 50% of 3.9375% MMCS Tax IGT Transfer + State Match (IGT Transfer +State Match) X 2 3.9375% of Increased Capitation $257,087 $51,417 $10,538 $267,625 $535,250 ($21,076) IGT Funds Available After Tax $514,174 CalOptima Retains 50% of Net $102,835 IGT Transaction Revenue Payment to City of Newport Beach Original Transfer + 50% of IGT Revenue $411,339 Program Timeline • June 26, 2oi6 - Signed Agreements Due • September 2oi6 - IGT Funds Transfer Request • October 2oi6 - CalOptima Receives Increased Capitation Payment • November 2oi6 - City Receives IGT Funds Questions? Medi -Cal Managed Care Rate Range Intergovernmental Transfer (IGT)