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Sheriff seeks to shift jail billing to America Choice to capture CalAIM reimbursements as board balks at $13.8M backfill
Summary
The San Diego County Sheriff asked the Board on March 24 to amend contracts to move administrative services from NavCare to America Choice (UnitedHealthcare/Amerit Choice) to capture CalAIM 90‑day pre‑release Medicaid reimbursements; the board approved most contract steps but rejected a $13.8 million appropriation to cover prior overruns.
The San Diego County Sheriff’s Office asked the Board of Supervisors on March 24 for authorization to amend its jail medical administrative services agreement and to seek a countywide solicitation for an administrative services organization (ASO), saying a change could stabilize hospital costs and allow the county to capture state Medicaid (CalAIM) reimbursements for 90‑day pre‑release services.
Sheriff Kelly Martinez and medical staff told the board that NavCare, the current contractor, has struggled to implement pre‑release billing and to negotiate favorable off‑site hospital rates, leaving the sheriff’s office exposed when off‑site claims exceed a previously negotiated cap. Commander Jesse Johns, who oversees medical services, said the sheriff’s medical division projects roughly $26.9 million in off‑site claims for the current contract year and expects an additional $7.6 million in over‑cap liability by May 31, 2026.
The sheriff’s office proposed moving administrative billing to America Choice (referred to in staff materials as Amerit/America Choice), arguing the company has experience implementing CalAIM billing and…
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