Date:
October 27, 2026 23
To: Board of Supervisors
Title
Authorize Pass-through Payment Model for Sheriff’s Amendment to Existing Administrative Services Organization Contract (Districts: All)
End
Overview
The San Diego County Sheriff's Office (Sheriff's Office) requests the Board of Supervisors (Board) authorize implementation of a pass-through payment model through the amendment to the existing United Healthcare agreement authorized by the Board on March 24, 2026. On March 24, 2026, the Board authorized amendment of the existing Administrative Services Organization (ASO) contract with United HealthCare Services, Inc. (AmeriChoice) to include the Sheriff's Office scope of work. During contract negotiations, the parties determined that Action 3.2, Item 3(c), requiring that the County of San Diego (County) not be responsible for cost overruns, cannot be implemented within the proposed ASO structure because AmeriChoice does not provide healthcare services or control the cost of medical care. The Sheriff's Office is legally responsible for ensuring that incarcerated individuals receive constitutionally and statutorily required medical care. As a result, the County remains responsible for funding medically necessary healthcare services provided to individuals in custody. Unlike the previous model under NaphCare, AmeriChoice will not provide medical care, determine medical necessity, control the utilization of medical services, or negotiate provider reimbursement rates on behalf of the County. Instead, AmeriChoice will act as a billing agent to support California Advancing and Innovating Medi-Cal (CalAIM) billing, a State program that allows reimbursement for certain healthcare services provided to justice involved individuals prior to release.
Costs of care are driven by the medical needs of the incarcerated population and the services provided by hospitals and specialty providers. Under the passthrough payment model proposed by Sheriff, because Amer...
Click here for full text