The Department of Health Care Services (DHCS) has uploaded four new hospital-directed files, 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 files include:
- Revised State Fiscal Year (SFY) 2017-18 Hospital Fee Program Payment Exhibits
Please disregard any Private Hospital Directed Payment (PHDP) exhibits released on July 24. This exhibit shows the final uniform add-on amounts for both inpatient days and outpatient/emergency room visits and the required payout from each contracted health plan. The contracted utilization has been broken down by county and by Affordable Care Act Medicaid Coverage Expansion (MCE) and non-MCE populations.
- Revised SFY 2018-19 Phase I Payment Exhibits
DHCS will be funding plans for SFY 2018-19 Phase I in September and hospitals can expect payments from plans 30-45 days thereafter.
- SFY 2017-18 and SFY 2018-19 Variance File
This exhibit details the variance between the original SFY 2017-18 amounts and the recalculated, final SFY 2017-18 amounts. Negative variances in the SFY 2017-18 amounts (i.e., originally calculated amounts in excess of the recalculated, final amounts) are not deemed to be earned directed payments under the PHDP program. DHCS expects these amounts to be offset by health plans against SFY 2018-19 Phase I payments. If funds for SFY 2018-19 Phase I are not enough to offset the negative balance, DHCS expects plans and hospitals to work together to identify methods to correct the imbalance. CHA plans to take these offsets into account with future distributions of managed care pass-through payments.
- Expanded SFY 2018-19 Phase 1 Hospital Directed Payment Data Set
This file contains three additional fields, including the final service count, inpatient type, and aid code group. This file will tie directly to the corrected PHDP display files, which covers the following service period:
- SFY 2018-19 Phase 1 (July 1, 2018–Dec. 31, 2018 service dates)