What’s happening: On Dec. 8, the Department of Health Care Services (DHCS) released the latest round of Medi-Cal managed care utilization data to hospitals and health plans, which is used to determine the amount of funding each hospital will receive in the Private Hospital Directed Payment Program.
What else to know: Hospitals should download their data from the DHCS secure site as soon as possible as uploaded files will be deleted within 45 days.
Hospitals should compare this data to their own utilization records and work with their contracted Medi-Cal managed care plans to reconcile any differences in order to get full credit and payment for contracted services provided during the program period.
The uploaded files cover the following service periods:
- Calendar Year 2022, Phase 2 (July 1, 2022 – Dec. 31, 2022)
- Calendar Year 2023, Phase 1 (Jan. 1, 2023 – June 30, 2023)
- Calendar Year 2023, Phase 2 (July 1, 2023 – Dec. 31, 2023)
If you did not receive an email from DHCS with this information and further instructions, or you are having challenges accessing your data from the secure site, please contact PrivateDP@dhcs.ca.gov.
