Coverage

About Coverage

Health care coverage is necessary for Californians to live fruitful, productive lives and all should have coverage so they can access their health care system. As of 2021, about 93% of Californians had some kind of health insurance, and as of June 2023, about 15.6 million people were enrolled in Medi-Cal. Coverage opens the door to care for wellness, chronic disease, emergency needs, and life-threatening illnesses, and more must be done to ensure equitable access, especially for populations that have gone far too long without it.

CHA Comments on Data Collection for MA Plans

What’s happening: CHA submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to a request for information related to data collection for Medicare Advantage (MA) plans. 

What else to know: CHA strongly encourages CMS to use the formal rulemaking process to implement additional data collection and reporting requirements. 

Medicare Coverage for Behavioral Health Expanded

What’s happening: The Department of Health Care Services (DHCS) announced that Medicare will cover visits with mental health counselors, addiction counselors, and marriage and family therapists, effective since Jan. 1. 

What else to know: The Centers for Medicare & Medicaid Services (CMS) will conduct both routine and focused program audits of Medicare Advantage (MA) organizations in 2024 to assess compliance with new requirements. 

CMS Provides “Two-Midnight Rule” Guidance for Medicare Advantage Plans

What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued a frequently asked questions (FAQ) document on finalized contract year 2024 Medicare Advantage (MA) policies.   

What else to know: The document provides guidance on how the “two-midnight” hospital admissions policies apply to MA patients when MA organizations are permitted to deny payment through post-claim audits.