CHA News

DHCS Takes Steps to Expedite Access to Enhanced Care Management

What’s happening: Effective Jan. 1, 2025, Medi-Cal managed care plans (MCPs) must implement presumptive authorization arrangement with select providers of enhanced care management (ECM). 

What else to know: The Department of Health Care Services (DHCS) is releasing updates to the ECM presumptive authorization policy parallel to the ECM Referral Standards that, together, are designed to ease the administrative burden of the referral and authorization process on ECM providers and community referral partners.  

CMS Updates Training on Post-Acute Care and More

What’s happening: The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training course on the post-acute care (PAC) patient assessment instruments (PAI) and quality reporting programs (QRPs) for all PAC settings.  

What else to know: The updated training provides a high-level overview of data elements within the patient/resident assessment instruments across PAC settings, including inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), long-term care hospitals (LTCHs), and home health (HH) agencies, and discusses the relationship between these data elements and the QRP for each setting.  

OSHPD to Host Webinar on Hospital Construction Review Process

What’s happening: The Department of Health Care Access and Information’s (HCAI) Office of Statewide Hospital Planning and Development (OSHPD) is hosting a webinar to share updates about its review process for hospital construction projects. 

What else to know: The webinar is scheduled for Sept. 25 at 1 p.m. (PT) and is free. Registration is open.  

Mental Health Parity Rules Finalized

What’s happening: The departments of the Treasury, Labor, and Health and Human Services have finalized rules to improve access to mental health services by requiring health plans to make changes when inadequate access is provided.   

What else to know: The final rule reinforces the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), which requires health plans to ensure that access to mental health or substance use disorder care is not more restrictive than access to medical and surgical benefits.  

CHA DataSuite Releases FFY 2025 Medicare SNF, LTCH, and IPF Prospective Payment System Final Rule Analyses

What’s happening: CHA DataSuite issued hospital-specific analyses of the federal fiscal year (FFY) 2025 Medicare skilled-nursing facility (SNF) and long-term care hospital (LTCH) prospective payment system (PPS) final rules.   What else to know: The analyses are intended to show hospitals how Medicare fee-for-service payments would change from FFY 2024 to FFY 2025 based on the […]

Eye on Washington — Health Care in Spotlight as Congress Reconvenes

With less than two months before America selects its next president, Congress has returned to Washington, D.C., to consider a federal funding plan, with action required before Sept. 30 to avoid a government shutdown. Given it is an election year, a shutdown is unlikely, and Congress will need to take temporary actions to keep programs operating.  

Update: Court Determines CHA Lawsuit Against Anthem is a “Complex Case”

What’s happening: A Los Angeles Superior Court Judge has designated a lawsuit brought by CHA against Anthem Blue Cross a “complex case,” requiring exceptional judicial management.  

What else to know: CHA’s suit challenges Anthem’s failure to authorize and arrange for access to timely and appropriate post-hospital health care services for its members. The next activity in the case will be an initial status conference on Oct. 3.  

CHA Issues Comments on CY 2025 OPPS Proposed Rule

What’s happening: CHA has submitted comments on the calendar year 2025 outpatient prospective payment system proposed rule.  What else to know: Comments were due to the Centers for Medicare & Medicaid Services (CMS) on Sept. 9. In the letter, CHA urges CMS to: 

Authors
  • Patricia Blaisdell, FACHE
    Vice President, Policy
  • Kirsten Barlow
    Vice President, Policy