TITLE
Recommendation to authorize City Manager, or designee, to execute agreements, and any subsequent amendments, with AppleCare Medical Group, Inc. (AppleCare), and Seaside Health Plan, an affiliate of MemorialCare Health System (Seaside), to provide clinical services to eligible enrollees under various health coverage plans, for a period of one year, with the option to renew automatically from year to year under the same terms and conditions. (Citywide)
DISCUSSION
AppleCare Medical Group, Inc. (AppleCare), and Seaside Health Plan, an affiliate of MemorialCare Health System (Seaside), have requested to enter into agreements with the City of Long Beach Health and Human Services Department (Health Department) to allow the Health Department to provide clinical services to eligible enrollees under various health coverage plans.
Under the terms of the agreements, enrollees will be referred to the Health Department, subject to the Health Department’s availability and capacity to provide such services. The Health Department will provide non-emergency “covered” health care services, and will bill each respective entity for services rendered. Under these agreements, and subject to capacity, the Health Department will be able to service more clients and receive revenue to offset the cost of providing services.
This matter was reviewed by Deputy City Attorney Taylor M. Anderson on June 12, 2019 and by Revenue Management Officer Geraldine Alejo on June 13, 2019.
TIMING CONSIDERATIONS
City Council action is requested on July 2, 2019, to ensure the agreements are in place expeditiously.
FISCAL IMPACT
The City will receive reimbursement revenue based on the number of referrals generated by AppleCare and Seaside in accordance with the allowable fee schedule. The number of referrals addressed through these agreements will be subject to the Health Department’s capacity to provide such services. Sufficient funds supporting staff and resources to implement the terms...
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