While CHA continues to press in Washington, D.C., for approval of the final component — fee-for-service payment mechanisms — of Hospital Fee Program 9, we are also pushing the state for timely completion of submission for the next iteration, Program 10.
In D.C., CHA is pulling on all levers for final approval, including working closely with members of California’s congressional delegation who have been advocating with Centers for Medicare & Medicaid Services (CMS) officials to get this over the finish line.
In June, CMS approved the largest elements of Program 9, which will ultimately result in a roughly $5.9 billion net benefit to California hospitals ($700 million more than the current program). Final approval of the full fee-for-service payments remains outstanding, but CMS has already approved a related technical component, so things are trending in the right direction.
Also, CMS has been communicating with state officials, and the state has been responsive to what appear to be routine questions from the federal government on fee-for-service payments.
For Program 10, which would be in effect for calendar year 2026, CHA, along with Private Essential Access Community Hospitals and the California Children’s Hospital Association, sent a letter earlier this month to the Department of Health Care Services (DHCS) urging the department to prioritize completion of its Program 10 package for CMS.
The letter urges DHCS to promptly finalize its Program 10 submission to secure approval as soon as possible to support hospital financial planning. DHCS has indicated it will send Program 10 to CMS by the end of September, which will make approval by the end of the year less likely.
We will continue to keep you posted on the fee-for-service component of Program 9 and the status of Program 10. If you have questions in the meantime, email Adam Dorsey, group vice president, financial policy, at adorsey@calhospital.org.
