DATE: August 19, 2025
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Interim Director, Department of Public Health
SUBJECT: Revenue and Coordination of Care Memorandum of Understanding with Managed Care Plans Blue Cross of California, CalViva Health, and Kaiser Permanente
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a Memorandum of Understanding (MOU) with Blue Cross of California Partnership Plan, Inc. dba Anthem (Anthem), Fresno-Kings-Madera Regional Health Authority dba CalViva Health (CalViva) and Kaiser Foundation Health Plan, Inc. (Kaiser), for the coordination of and compensation for services provided by the Department of Public Health to Anthem, CalViva, and Kaiser Medi-Cal Managed Care members effective upon execution by all parties with unlimited 12 month auto-renewals unless terminated by any party, for an annual estimated amount of $99,700.
REPORT
Approval of the recommended action will allow the Department of Public Health (DPH) to seek claims reimbursement from the California Department of Health Care Services (DHCS) Medi-Cal program and to coordinate care with the Medi-Cal Managed Care Plans (MCPs) for Medi-Cal Managed Care (MCMC) beneficiaries who receive DPH services. It is anticipated that MCMC claims will generate approximately $99,700 in FY 2025-26 with no Net County Cost. Estimated reimbursements for subsequent years will be budgeted annually. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, DPH would be unable to bill the MCPs for services provided as outlined in this MOU; however, DPH would retain responsibility to provide these services to low-income Fresno County residents. Entering into this MOU allows for DPH to bill for services that would otherwise be uncompensated.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The MOU will allow reimbursement to the County for public health services prov...
Click here for full text