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On Jan. 12 the Department of Health Care Services (DHCS) sent hospitals invoices covering the first six fee-for-service cycles of the 2017-19 Hospital Fee Program. The first invoice has a due date of Feb. 5; hospitals will receive the first fee-for-service payment on Feb. 26. On Friday, CHA distributed hospital-specific schedules to assist in tracking when the fees are due to DHCS and when fee-for-service payments should be received. The schedules were created using the draft model that was sent to hospitals last week in CHA News, and include an estimate of the pledge contribution to the California Health Foundation and Trust (if applicable). The information in the schedules represents CHA’s best estimates based on the portions of the program currently approved by the Centers for Medicare & Medicaid Services. If any hospital does not pay its fees to DHCS in full and on time, all hospitals will receive decreased supplemental fee-for-service payments.
CHA has also included estimates for the Medi-Cal managed care components of the 2017-19 Hospital Fee Program. However, it is important to note that the managed care components of the program have not been approved by the Centers for Medicare & Medicaid Services and, therefore, the payment amounts in the draft model are very preliminary. Furthermore, the supplemental Medi-Cal managed care payments made through the new directed payment mechanism have been estimated using inpatient utilization data publicly reported to the Office of Statewide Health Planning and Development for the fiscal year ending in 2015. However, in actuality, the directed payments will be made for inpatient and outpatient services provided to in-network patients during the current state fiscal year. CHA will continue to update members through CHA News; all updates can be found on the CHA website.
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