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OHCA to Finalize Data Collection Requirements in the Coming Weeks

What’s happening: This week, OHCA released a close-to-final draft regulation and supplemental guidance on the total health care expenditure data collection process, which contains few substantive changes from the prior draft version.  

What else to know: Payers remain responsible for reporting the data under the revised guidance. CHA remains concerned about the lack of transparency and standardization and urges members to contact OHCA on its related spending target proposal using the template letter and talking points included in this week’s alert.  

CMS Updates Hospital Guidance for Texting Patient Info

What’s happening: The Centers for Medicare & Medicaid Services (CMS) updated guidance for hospitals and critical access hospitals related to texting patient information.  

What else to know: Hospitals should use a Health Insurance Portability and Accountability Act-compliant secure texting platform that complies with Medicare and Medicaid conditions of participation.  

Changes Proposed for Accrediting Organizations Requirements

What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued proposed changes to accrediting organization (AO) requirements.  

What else to know: The proposed changes are intended to strengthen the agency’s oversight of AOs and prevent conflicts of interest. Comments are due to CMS by 2 p.m. (PT) on April 15.  

CHA Opinion Piece Shines Light on Insurer Crisis in Orange County

What’s happening: CHA President & CEO Carmela Coyle shares how vulnerable Californians in Orange County are losing access to health care because an insurance company is dropping safety-net hospitals.  

What else to know: CalOptima has dropped from its network four hospitals that serve people experiencing homelessness, substance abuse disorders, chronic health conditions, and more. CHA is calling for regulators to take action to preserve health care access for California’s most vulnerable patients.   

Federal Judge to Determine Legality of Health Care Employer Provisions in City of Inglewood Ordinance

What’s happening: In a lawsuit brought by CHA, a federal judge is set to rule on whether portions of an Inglewood ordinance conflict with the National Labor Relations Act (NLRA).   

What else to know: The ordinance increases minimum wage for health care workers at a broad range of health care facilities yet prohibits employers from using lawful economic bargaining tools to fund the increase. CHA is not challenging the increased minimum wage.  

Medicare Coverage for Behavioral Health Expanded

What’s happening: The Department of Health Care Services (DHCS) announced that Medicare will cover visits with mental health counselors, addiction counselors, and marriage and family therapists, effective since Jan. 1. 

What else to know: The Centers for Medicare & Medicaid Services (CMS) will conduct both routine and focused program audits of Medicare Advantage (MA) organizations in 2024 to assess compliance with new requirements. 

CMS Provides “Two-Midnight Rule” Guidance for Medicare Advantage Plans

What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued a frequently asked questions (FAQ) document on finalized contract year 2024 Medicare Advantage (MA) policies.   

What else to know: The document provides guidance on how the “two-midnight” hospital admissions policies apply to MA patients when MA organizations are permitted to deny payment through post-claim audits. 

CHA DataSuite Released Medicare Hospital FFY 2025 Wage Index and Occupational Mix Revised Data Analysis

What’s happening: CHA DataSuite has issued a hospital-specific analysis of the Medicare hospital federal fiscal year (FFY) 2025 wage index and occupational mix data. 

What else to know: The data has been revised and is the second of three wage and occupational mix data public use files (PUFs) that the Centers for Medicare & Medicaid Services (CMS) issued to develop the hospital wage index for FFY 2025.