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Board committee approves amended DPH contract for Medi‑Cal recovery services
Summary
The Board’s budget and finance subcommittee approved an amended retroactive contract between the Department of Public Health and Health Advocates LLC to pursue Medi‑Cal reimbursement recoveries; analysts said the work could generate substantial gross recoveries and recommended lowering the contract’s not‑to‑exceed cap.
The San Francisco Board of Supervisors’ Budget and Finance Subcommittee approved a retroactive contract on March 5 to hire Health Advocates LLC to perform uncompensated care reimbursement recovery services for the Department of Public Health. Chair Supervisor Mark Farrell and the committee moved the item forward without objection after the budget analyst recommended reducing the contract cap.
DPH Deputy Financial Officer Anna Kubo told the committee the contractor will represent patients in Medi‑Cal appeals, evaluate eligibility, assist in applications and help the department bill for services it otherwise cannot recover. DPH estimated gross recoveries of $34,400,000 over the contract period; after contractor fees the department projected a net revenue of about $28,100,000.
Budget analyst Mr. Rose reported the total estimated fee payments DPH would make to Health Advocates over a four‑year term are $5,580,390 and that the contract also contains a $720,000 contingency related to third‑party reimbursements. He recommended amending the resolution to lower the proposed not‑to‑exceed amount to $6,300,390 and approving the resolution as amended. Supervisor John Avalos moved to accept the budget analyst’s recommendations, and the committee approved the item as amended without objection.
The Clerk was directed to receive the amended contract from the Department by 9 a.m. the following day.
The committee’s action sends the updated contract forward to the full Board for final placement on the March 11 agenda.
