What’s happening: On June 13, the Department of Health Care Services (DHCS) uploaded three new hospital-directed payment encounter files, available via the Secure File Transfer Protocol site, that hospitals must download as soon as possible — they will be deleted within 45 days of the upload date.
What else to know: These data sets include Managed Care Provider Network 274 data as outlined in All Plan Letter 16-019.
The hospital-directed payment encounter files cover the following service periods:
- Calendar Year (CY) 2024 Phase 1 (Jan. 1–June 30, 2024, service dates). The file name will be Name_CY2024P1
- CY 2024 Phase 2 (July 1–Dec. 31, 2024, service dates). The file name will be Name_CY2024P2
- CY 2025 Phase 1 (Jan. 1–June 30, 2025, service dates). The file name will be Name_CY2025P1
DHCS has also published new CY 2023 encounter detail file toolkits for each directed payment program.
The department expects plans and participating hospitals to work together to identify and address deficiencies in encounter data accuracy and/or completeness. Hospitals should contact the department directly at privatedp@dhcs.ca.gov with any questions or if they cannot access their data.
CHA will share updated release dates for CY 2024 and CY 2025 in upcoming communications; all future dates are subject to change.
More information is available in the guidance document.
