On Friday, the Department of Health Care Services (DHCS) released three new hospital-directed payment data sets, available via the Secure File Transfer Protocol site (the site is only intended for file transfers, and uploaded files will be deleted within 45 days).
The data cover:
- Bridge Period 2019-20 Phase 3 (July 1-Dec. 31, 2020, service dates). The name of the file will be Name_BP1920P3.
- Calendar Year 2021 Phase 1 (Jan. 1-June 30, 2021, service dates). The name of the file will be Name_CY2021P1.
- Calendar Year 2021 Phase 2 (July 1-Dec. 30, 2021, service dates). The name of the file will be Name_CY2021P2.
The data file with Bridge Period 2019-20 Phase 3 (July 1-Dec. 31, 2020) is the “first pass” at identifying contract status. This contract flagging status file is due no later than close of business on Jan. 21, 2022. As a reminder, the final due date for any new or edited encounter data to be submitted to DHCS for consideration within the bridge period Phase 3 calculation is Dec. 31, 2021.
Reminder: This is an important step in the state’s effort to calculate managed care directed payments that are expected to process in September 2022. Any encounters that are not accurately populated with a contract status flag (“C” indicates contracted, “N” indicates non-contracted, and “H” indicates a hospital-to-hospital contract) will be defaulted by DHCS to “N” — non-contracted — and will not count toward any directed payments.