Agenda - 09-17-2024; 8-h - Fee Schedule Changes for Health Department

Browse Search

1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: September 17, 2024 Action Agenda Item No. 8-h SUBJECT: Fee Schedule Changes for Health Department DEPARTMENT: Health ATTACHMENT(S): INFORMATION CONTACT: August 28, 2024 Board of Health Proposed Fee Changes Agenda Item Frederick Perschau, Finance and August 28, 2024 Board of Health Administrative Services Director, Proposed Fee Changes Agenda Item 919-245-2414 Addendum FY 2024-25 New Fees Requested Spreadsheet Environmental Health Fee Change Information PURPOSE: To establish and update fees as recommended by the Board of Health for certain personal health, dental health and environmental health services to assist in cost recovery. BACKGROUND: According to North Carolina General Statute (NCGS) 130A, the Board of Health is responsible for reviewing and recommending fees to the Board of County Commissioners in order to recover costs for those services for which fees may be charged. Establishment of fees also allows the Health Department to recover costs from third parties such as Medicaid, Medicare, and private insurance. A standard fee must be established that is charged to a patient or client regardless of their insurance status. The Health Department also has established a sliding fee scale to charge patients/clients based on income. At its August 28, 2024, meeting, the Board of Health reviewed and approved the proposed fees, recommending that the changes move forward to the Board of Commissioners for action. While the charge for the service is always the same, the amount collected by the Health Department varies according to the payor source. Twice a year, Medicaid reviews and makes rate adjustments based on the experience with various providers throughout the state. The department reviews and adjusts its fees based on this review to ensure that the maximum income allowed by Medicaid for a certain procedure can be recovered to defray the costs for providing a particular service. The Department reviews fees annually as part of budget process, however, sometimes changes in policy at the state level lead to a change in the fee structure, or a change in best practice for medical care dictates changes that fall outside of the budget cycle. The Medicaid Cost Settlement methodology requires that the Health Department examine its existing fees. In doing so, staff used the following methodology: 1. Increased fees to the regional cost average rather than the actual cost if it was significantly higher 2. Decreased fees if the actual cost was less than the current fee