This post has been archived and contains information that may be out of date.
On Oct. 19, CHA delivered Hospital Fee Program 7 (2022) payment schedules to hospitals and Medi-Cal managed care plans. These schedules detail what health plans will pay which hospitals and how much they should pay.
As you know, in late August, the Department of Health Care Services (DHCS) collected the fees associated with the Hospital Quality Assurance Fee Program 7 passthrough payments from hospitals. While these managed care rates have not been formally approved by the Centers for Medicare & Medicaid Services, DHCS processed the supplemental capitation payments to the Medi-Cal managed care plans in August and health plans received the passthrough funding in their capitation payments in late September. Based on the information reported to CHA by the Medi-Cal managed care plans, the Program 7 passthrough payments are expected to be paid at approximately 99% of the modeled amounts included in the schedules hospitals received last year when Program 7 received federal approval.
As part of the schedules sent to health plans, CHA has also alerted the plans of the expectation to make the payments as soon as possible, but no later than Nov. 3. If your hospital has not heard from a plan on your schedule or has not received payment by that date, please reach out to the plan(s) to inquire when to expect payment. If your hospital continues to have challenges, please reach out to CHA.
CHA attempted to schedule payments to individual hospitals in a way that was similar to previous passthrough cycles. However, given shifts in how much funding was received by each plan and/or the amount due to a particular hospital compared to previous years there may be situations where your hospital will be receiving funds from a plan that it had not previously. We apologize for any inconvenience this may cause, but this was simply unavoidable. If you need contact information for a particular plan, please reach out to CHA and we will be happy to assist.
Also, when the schedules were distributed to hospitals due to the volume of undeliverable e-mails, it was clear that CHA may not have the most recent contact information for your hospital. If you did not receive your schedule, please reach out to CHA so we can send it to the appropriate contacts at your organization.
Please contact Robert Ducay at rducay@calhospital.org or (916) 552-7643 with any questions or concerns.
