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 covers:
- Bridge Period 2019-20 Phase 2 (Jan. 1-June 30, 2020 service dates)
- Bridge Period 2019-20 Phase 3 (July 1-Dec. 31, 2020 service dates)
- Calendar Year 2021 Phase 1 (Jan. 1-June 30, 2021 service dates)
Later today, DHCS will revise the Bridge Period 2019-20 Phase 2 (Jan. 1-June 30, 2020) file. If the Phase 2 file was downloaded on Friday, please replace it with the Sept. 13 version.
The data file with Bridge Period 2019-20 Phase 2 (Jan. 1-June 30, 2020) is in its “final pass” at identifying contract status. Due to the revised file that will be posted later today, DHCS has extended the deadline for reporting contract status to DHCS until close of business on Oct. 25. It is important to remember that some plans have internal deadlines that are shorter than the DHCS deadline of Oct. 25. With that in mind, every hospital should reach out to Medi-Cal managed care plans they hold contracts with to ensure they do not miss their deadlines to reconcile contractual differences.
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.