CHA News

CMS Approves Hospital Fee’s 2022 Managed Care Private Hospital Directed Payment Program

For CFOs, finance & reimbursement directors

This post has been archived and contains information that may be out of date.

On May 10, the Centers for Medicare & Medicaid Services (CMS) approved the Department of Health Care Services Private Hospital Directed Payment (PHDP) program for the Jan. 1-Dec. 31, 2022, managed care rate year. 

The PHDP program provides supplemental payments in the form of uniform dollar increases for inpatient and outpatient contracted services provided by private hospitals to Medi-Cal managed care beneficiaries and is part of Program 7 of the Hospital Fee Program.  

While the letter approves the overall PHDP structure, it does not constitute approval of the Medicaid managed care plan contracts or rate certifications for the 2022 rating period.  It is also not approval of the broader hospital fee and payment financing mechanism used to support the provider payment arrangement, which is still pending CMS approval.  

A link to the approval letter can be found on the CHA website under the Hospital Fee Program Status for Program 7.