Agenda - 12-06-2004-5g - Laserfiche WebLink

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ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: December 6, 2004 Action Agenda Item No. q SUBJECT: Dental and Primary Care Fees for the Health Department DEPARTMENT: Health PUBLIC HEARING: (Y/N) No ATTACHMENT(S): Dental Fee Adjustment Schedule Primary Care Fee Schedule INFORMATION CONTACT: Rosemary Summers, ext 2411 TELEPHONE NUMBERS: Hillsborough 732-8181 Chapel Hill 968-4501 Durham 688-7331 Mebane 336-227-2031 PURPOSE: To approve dental fee adjustments based on Medicaid adjustments and to approve fees for primary care services that will begin January 1, 2005, BACKGROUND: The State revises Medicaid reimbursement levels twice a year, Based on the most recent adjustment on October 1, 2004, the Board of Health is recommending that four dental fees be adjusted and two new fees created by Medicaid be established with the charges as indicated in the attached spreadsheet. In addition, the Health Department is beginning limited primary care services on January 1, 2005 as approved by the Board of Commissioners as part of the regular budget approval process. There are a number of procedures that the Health Department previously did not provide and therefore there were no established fees for these procedures. The attached fee schedule includes additional procedures that may be needed in the delivery of primary care, It should be noted that some laboratory charges are lower than the actual Medicaid rate. For those tests, the Health Department uses the UNG Hospitals' McLendon Labs and may only charge the actual charge to the County from the lab, All fees have been reviewed and approved by the Board of Health, All new fees are established by examining current reimbursement rates by Medicaid, by private pay fees and by estimating cost to provide the service by the Health Department. All adjustments to fees once established are based on either a cost study (performed once every 5 years) or adjusted in accordance with Board of Health adapted Fee and Eligibility Policies. All fees for Personal Health and Dental Health services are subject to a sliding fee scale, FINANCIAL IMPACT: Income from these fees were part of the budget projection for the start- up of primary care. The fees are established to provide for full cost recovery of the services provided. However, since the Health Department operates on a sliding fee scale, 100% cost recovery of service provision is not likely since 75-80% of the Health Departments' patients are below 200% of the federal poverty level,