The Hospital Quality Assurance Fee (HQAF) Program and all of its statutory provisions were made permanent through the passage of CHA’s ballot initiative, the Medi-Cal Funding and Accountability Act (Proposition 52), in the November 2016 general election. While this provides the framework for all future hospital fee programs, future iterations must adhere to federal regulations related to health-care provider taxes. Further, the Department of Health Care Services (DHCS) must obtain all necessary federal approvals.
For each hospital fee program, the Centers for Medicare & Medicaid Services (CMS) must approve:
The provider tax waiver, which covers the fee structure used to support the non-federal share of Medi-Cal supplemental payments
Medi-Cal fee-for-service (FFS) state plan amendments, which cover the FFS supplemental payments
Medi-Cal managed care rates and contracts, which cover the managed care supplemental payments
While some federal approvals (e.g., provider tax waiver, FFS state plan amendments) cover the entire hospital fee program, others require review/approval on an annual basis (e.g. managed care rates/contracts). Included below are the hospital fee program federal approvals received to date, for the programs beginning on or after January 2014.
Patient Overcomes Painful Vascular Condition with Life-Changing Treatment
JanMichael learned she had chronic venous insufficiency at 74, she turned to Eisenhower Desert Cardiology Center for help. Thanks to Dr. Wick’s recommendation for a radiofrequency vascular ablation, she now feels a huge difference in her daily life: “After all the years I suffered with this, I feel like I have new legs,” Schulist said.
What’s happening: On Dec. 13, 2024, the Department of Health Care Services (DHCS) uploaded three new hospital-directed payment encounter files, available via the Secure File Transfer Protocol site, that hospitals must download as soon as possible — they will be deleted within 45 days of the upload date.
What else to know: DHCS has also published new calendar year 2023 encounter detail file toolkits for each Directed Payments program.
CHA Webinar Covers New Medicare Conditions of Participation Updates
What’s happening: CHA will host a members-only webinar on Jan. 29 from 11 a.m. to noon (PT) to discuss the new Medicare Conditions of Participation (CoP) updates for obstetrical and other services. Registration is open.
What else to know: The requirements will be phased in over two years, with the first of the requirements in effect July 1.
CMS Now Requires Annual Reporting of Hospital Respiratory Data for Certain Facility Types
What’s happening: Effective January 2025, the Centers for Medicare & Medicaid Services (CMS) requires certain facility types to report hospital respiratory data (HRD) to the National Healthcare Safety Network on an annual basis.
What else to know: All required data elements and reporting information can be found in the HRD Reporting Protocol.
CMS Proposes Payment Updates for Medicare Advantage, Part D Plans for CY 2026
What’s happening: On Jan. 10, the Centers for Medicare & Medicaid Services (CMS) issued advance notice of proposed capitation rate and payment updates for Medicare Advantage (MA) and Part D plans for calendar year (CY) 2026.
What else to know: The final 2026 rate announcement is expected by April 7.
DHCS Shifts Deadline for Hospital Fee Program Payments to April 8
What’s happening: As previously shared with member hospitals via email, the Department of Health Care Services (DHCS) has shifted the timing of fees and payments for the Hospital Quality Assurance Fee (HQAF) program attributable to the managed care pass-through cycle for the Jan. 1, 2024, through Dec. 31, 2024, period.
What else to know: The fees associated with this cycle are now due April 8, 2025.
Registration Open for Chief of Staff Boot Camp 2025
What’s happening: The Institute for Medical Leadership is hosting its Chief of Staff Boot Camp 2025 — geared toward medical staff leaders, chief medical offers, hospital executives, and medical staff managers — Feb. 28 to March 2 in Los Angeles. Tuition begins at $2,195, and registration is open.
What else to know: The Chief of Staff Boot Camp aims to provide new chiefs of staff the information they need to succeed in their complex role by sharing the knowledge and tools necessary to work collaboratively with peers, hospital administration, and staff members.
HCAI Releases White Paper on Seismic Instrumentation
What’s happening: The Department of Health Care Access and Information’s (HCAI) recent white paper covers how useful and beneficial it is for health care facilities to utilize seismic instrumentations, such as various sensors that measure accelerations and displacements.
What else to know: The paper was developed by the Hospital Building Safety Board’s Instrumentation Committee and its information is valuable to hospital owners and managers, operators, design professionals, public officials, and the general public.
CDPH Releases Updated Return to Work Guidance for Health Care Personnel with Respiratory Viral Infections
What’s happening: On Jan. 10, the California Department of Public Health released updated Interim Work Exclusion Guidance that details when health care personnel with COVID-19, influenza, and other acute respiratory viral infections may return to work.
What else to know: The guidance, announced in an All Facilities Letter, applies regardless of whether diagnostic testing for viral pathogens is performed or the results of such testing is confirmed. This guidance does not apply to novel viral pathogens, including avian influenza, for which other public health guidance is available.
