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.

Questions? Contact Adam Dorsey, group vice president, financial policy, at adorsey@calhospital.org, or Jesse Delis, vice president, financial policy, at jdelis@calhospital.org

When Arash and his wife Stephanie were diagnosed with cancer, City of Hope gave them the support and care they needed to survive, change their lifestyle, and live more authentically.  

In April 1974, President Richard Nixon signed Presidential Proclamation 4288, creating National Volunteer Week. Every year since then, each president has issued a new proclamation commemorating this celebration of those who give freely of their time to help others. 

What’s happening: In just over two weeks, the 2025 Emergency Services Forum will take place in Newport Beach, where emergency services professionals will gather for a day of learning, discussion, and networking. Registration is open. 

What else to know: At the forum, to be held May 5 from 8 a.m. to 4 p.m., attendees can expect dynamic sessions covering the latest updates in emergency services, insights into the evolving behavioral health landscape, an interactive Q&A forum, a closing session on the Emergency Medical Treatment & Labor Act, and more.  

What’s happening: Multiple bills addressing insurer accountability have been introduced in the California State Assembly during the current legislative session. On behalf of its member hospitals, CHA is supporting several bills that would improve the prior authorization process by reducing response times, clarifying reviewer qualifications, and/or reducing or eliminating prior authorization for certain services.   

What else to know: CHA is also supporting bills that would require greater plan transparency for review, approval, and appeal results.  

What’s happening: On April 11, the Centers for Medicare & Medicaid Services (CMS) issued its federal fiscal year (FFY) 2026 inpatient psychiatric facility (IPF) prospective payment system (PPS) proposed rule.  

What else to know: Comments on the proposed rule are due to CMS by June 10.  

What’s happening: On April 11, the Centers for Medicare & Medicaid Services (CMS) released the federal fiscal year (FFY) 2026 inpatient prospective payment system (IPPS) proposed rule — which falls short of what hospitals need to keep up with rising costs and health care needs.   

What else to know: As a result of all proposed changes, CMS estimates that hospital inpatient payments will increase by $4 billion in FFY 2026. Comments on the proposed rule are due June 10.   

What’s happening: At its April 22 board meeting, the Office of Health Care Affordability (OHCA) board will review stakeholder feedback on staff’s recommended hospital sector spending targets and could adopt the proposal in its current, or a modified, form. CHA urges hospital representatives to submit letters in opposition by April 18 and attend the meeting, either in person or virtually, to provide public comment asking the board reject the proposed hospital sector target recommendations.  

What else to know: The board has until June 1 to adopt any new targets for the 2026 calendar year — including for a hospital sector. If no action is taken this month, a decision could come at OHCA’s May 27 board meeting. 

What’s happening: On April 7, the U.S. District Court for the Northern District of Texas vacated key portions of the minimum staffing requirements for skilled-nursing facilities (SNFs) mandated by the Centers for Medicare & Medicaid Services (CMS).  

What else to know: The court ruled that CMS’ standardized numerical minimums were inconsistent with existing federal law passed by Congress in 1987.  

What’s happening: The Hospital Quality Institute’s (HQI’s) fourth and final webinar on reporting hospital equity measures to the California Department of Health Care Access and Information (HCAI) under Assembly Bill 1204 (2021) will take place April 23 from 10-11 a.m. (PT). 
 
What else to know: This webinar will share essential updates on HQI’s tool to aid hospitals in creating their health equity report, due to HCAI by Sept. 30, and walk attendees through the submission portal. Registration is open.  

What’s happening: At the inaugural Proposition (Prop) 35 “Protect Access to Health Care Act” Stakeholder Advisory Committee meeting, held April 14, CHA and other stakeholders urged the Department of Health Care Services (DHCS) to move forward quickly with a payment methodology that meets two primary goals.  

What else to know: Stakeholders urged the committee to develop a payment methodology that will not only be approved by the Centers for Medicare & Medicaid Services (a requirement for the state to receive federal funding), but also ensure that hospitals receive 2025 and 2026 payments — totaling as much as $1.4 billion — without unnecessary delays.