Search Results for: "MCO & HFP"

Showing 1 - 10 of 213 results

Proposed Changes to Medicaid Health Care-Related Tax Rules Threaten MCO Tax, Hospital Fee Program

What’s happening: The Centers for Medicare & Medicaid Services (CMS) has issued proposed changes to the Medicaid health care-related tax rules that present significant risks for California’s managed care organization (MCO) tax and Hospital Quality Assurance Fee Program — both of which hospitals rely on to deliver patient care. Comments on the proposed rule are due to CMS by July 14. 

DHCS Submits Hospital Fee Program 9 Fee and Payment Model, Draft Available for Members

What’s happening: On March 28, the Department of Health Care Services (DHCS) submitted a final draft of the Hospital Quality Assurance Fee (HQAF) program 9 fee and payment model to the Centers for Medicare & Medicaid Services (CMS). An internal, members-only version   is available for members to review. 

What else to know: The model should be considered a draft until the state receives official CMS approval, which is expected to take six to nine months. Learn more about the 2025 HQAF program 9 — including a brief history, a summary of changes, and the future landscape of the program — in our members-only webinar on April 7 at 9 a.m. (PT).  

MCO Funding Must be Restored

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California’s Legislature has a little more than a week to finalize the state budget for the coming year — no small task given the multibillion-dollar, multiyear deficit at hand. 

Updated MCO Tax Ballot Language Reflects Compromise

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Last week, the Coalition to Protect Access to Care submitted final revised ballot initiative language for the Protect Access to Healthcare Act of 2024. It would permanently authorize the managed care organization (MCO) tax in state law and dedicate the majority of associated revenues to improving Medi-Cal provider payments in targeted service categories.  

The language was amended to address concerns related to the state budget, as well as other stakeholder concerns. If approved by voters, the final language will:  

CHA Issues FAQs on MCO Tax Budget Agreement 

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CHA has issued Frequently Asked Questions (FAQ) regarding the 2023 state budget agreement on the managed care organization (MCO) tax. The agreement renews the tax and commits the majority of the funding to provider payment increases, including for hospitals.

Ballot Initiative Would Dedicate MCO Tax Revenue to Fund Medi-Cal

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What’s happening: The Coalition to Protect Access to Care has submitted more than 800,000 voter signatures to qualify the Protect Access to Healthcare initiative for California’s November 2024 ballot.  

What else to know: CHA supports the proposed ballot measure, which would permanently channel managed care organization (MCO) tax revenue to Medi-Cal providers such as hospitals, physicians, women’s health and community clinics, and health centers.  

CHA Analysis: Proposed MCO Tax Spending Plan Maintains Key State Commitment

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What’s happening: On Jan. 20, the California Department of Health Care Services (DHCS) published its spending plan on how the Newsom administration proposes to spend almost $2.7 billion in annual managed care organization (MCO) tax funds to improve Medi-Cal reimbursements. 

What else to know: CHA expects the proposal to be refined and finalized by July 2024 and implemented starting in 2025. 

Prop 35 Passage Kickstarts Work to Develop, Implement Methodologies to Distribute Funding

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What’s happening: On Nov. 5, California voters overwhelmingly approved Proposition (Prop) 35, making an existing tax on managed care organizations (MCO) permanent under state law — and directing most of the revenues toward expanding access to care for Medi-Cal patients through improved provider reimbursement. Now, work by the state, hospitals, and others to determine how these funds should be distributed begins. 

What else to know: While Prop 35 specifies how much funding shall go to several different service categories, it does not set the methodologies for distributing the funds. The ball is now in the Department of Health Care Services’ court to develop these payment methodologies — in consultation with hospitals and other providers, including through a dedicated stakeholder advisory committee.