LA County Board

33. Government Programs, Health Plans, Insurance Companies and Healthcare Providers Payer Agreements Revised recommendation: Authorize the Director of Health Services to negotiate, execute, and terminate new agreements for a duration of one year or more, with government, commercial, and private payers, or their subcontracted healthcare (Payer Contracts), to compensate the County for the provision of inpatient, outpatient, and other healthcare services provided by the Department of Health Services (DHS) hospitals and health centers (County Healthcare Services). This delegation shall include, without limitation, the ability to specify methods and rates of payment that are appropriate for the services rendered thereunder, including capitated payments, as well as the authority to exclude or revise certain County standard contractual terms while remaining in compliance with applicable laws and regulations. Such authority shall remain in effect for a period of five years through June 30, 2031. Payer Contracts shall be subject to submission to the Chief Executive Office (CEO) and Board in its then-current draft form with feedback provided to DHS within five calendar days thereafter, and subsequent notification to the CEO and the Board. Authorize the Director to take the following actions: (Department of Health Services) APPROVE (Continued from the meeting of 6-16-26) Negotiate, execute and terminate amendments to existing or future Payer Contracts, including to adjust rates or modes of payment, including service/capitation rates and incentive payments, add or remove lines of business or service lines into or out of such Payer Contracts, improve or update clinical and/or administrative operations within the Payer Contract’s scope of services, extend or terminate the term of the Payer Contract in accordance with contract terms, adjust division of financial responsibility under relevant Payer Contracts, update or incorporate new State/Federal law and regulations, County policies, accreditation requirements, and other authorities, and take any additional actions required by contracts, rules, and guidelines. Amendments to Payer Contracts shall be subject to submission to the CEO and the Board in its then-current draft form with feedback provided to DHS within five calendar days thereafter, and subsequent notification to the CEO and the Board. Negotiate, prepare, and accept Medi-Cal related incentives, awards, and other payments whether deriving from Federal or State governments or health plans, with notice to the Board and the CEO. Negotiate, execute and terminate letters of agreement for a duration of six months or less with Healthcare Payers (Payer LOAs), to compensate the County for the provision of certain County Healthcare Services for which DHS has identified clinical service line capacity. LOAs shall be limited to one six-month extension. This delegation includes the authority to set methods and rates of payment, as well as the authority to exclude or revise certain County standard contractual terms while remaining in compliance with applicable laws and regulations. Such authority shall remain in effect for a period of five years through June 30, 2031, subject to notice to the Board and the CEO. Negotiate, execute and terminate amendments to existing or future existing Payer Contracts and Payer LOAs, including to adjust rates or modes of payment, including service/capitation rates and incentive payments, add or remove lines of business or service lines into or out of such Payer Agreements LOAs, improve or update clinical and/or administrative operations within the Payer Agreement’s LOA’s scope of services, extend or terminate the term of the Payer Agreement LOA in accordance with the agreement LOA terms, adjust division of financial responsibility under relevant Payer Agreements LOAs, update or incorporate new State/Federal law and regulations, County policies, accreditation requirements, and other authorities, and take any additional actions required by contract LOA, rules, and guidelines; subject to notice to the Board and the CEO. Such authority shall remain in effect for a period of five years through June 30, 2031. Negotiate, execute, and terminate agreements with existing or new contracts or subcontracts with third party vendors to adequately support the delivery of services DHS is required to provide under existing or newly executed DHS agreements with Healthcare Payers that include capitation or other risk-bearing payment models, stemming from the recommendations above, subject to notice to the Board and the CEO. Enter into and terminate, revised and expanded Fast Track Agreements (FTA), which modifies the prior FTA and related policy authorized by the Board on August 8, 2002, as follows: expands the FTA Policy to apply not only to DHS hospitals, but also to DHS health centers; eliminates the previously established minimum negotiated rate guidelines. (26-3396) Revised Board Letter