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2017-19 Hospital Fee Program Managed Care Invoices Due Feb. 18

For CFOs

This week, the Department of Health Care Services (DHCS) will send hospitals invoices covering the second phase of managed care directed payments (“MC2 DP(B)”) of the 2017-19 Hospital Fee Program, covering Jan. 1 – June 30, 2018. Payments are due Feb. 18.

While these rates have not been formally approved by the Centers for Medicare & Medicaid Services (CMS), DHCS will make the supplemental capitation payments to the Medi-Cal managed care plans in mid to late March. Hospitals can expect to begin receiving payments from Medi-Cal managed care plans by the end of May.

DHCS will email the final results for the MC2 DP(B) phase to its hospital contacts around mid-February. These emails will include the final directed payment amounts separated by inpatient ($776.67 per in-network IP day) and outpatient ($100.70 per in-network ER/OP visit) for each hospital, and from which health plan. By the end of February, DHCS will post the final detail files for MC2 DP(B) to its secure file transfer protocol site, which will include the accepted encounter level information and contract status.

As a reminder, the invoices include new payment instructions that allow hospitals to utilize DHCS’ electronic funds transfer website. It is critical that all hospitals pay their invoices in full and on time.

Questions about DHCS’ list of hospital contacts should be directed to DHCS directly [email protected].