About Finance & Reimbursement
Vulnerable Californians who rely on the care provided by California hospitals are at risk. Driven by skyrocketing costs for labor, pharmaceuticals, regulatory mandates, and more, 53% of all hospitals statewide lose money every day to deliver patient care.
That isn’t sustainable. And California is already seeing the frightening result: rural health care services being cut to the bone, severe behavioral health care needs not being met, and more.
OHCA: The Progressive Enforcement Process
DHCS Provides Guidance on Fee-For-Service Transition
What’s happening: The Department of Health Care Services (DHCS) has published new resources to support Medi-Cal members, providers, and partners ahead of the Jan. 1, 2027, transition of members with unsatisfactory immigration status from managed care to fee-for-service.
Health Care Leaders Urged to Apply for Financial Solvency Standards Board
What’s happening: The Department of Managed Health Care (DMHC) is seeking up to four people to serve on the Financial Solvency Standards Board (FSSB). Interested candidates must submit required documents by Oct. 2.
State Budget Includes Key Health Care Provisions
What’s happening: Earlier this week, the Senate, Assembly, and governor reached agreement on the revised 2026-27 state budget. The Senate and Assembly then approved trailer bill measures — including Assembly Bill (AB) /Senate Bill (SB) 173 and AB/SB 113, which relate to health care.
Hospitals Should Plan to Attend MCP Value-Based Payment Contracting Conference
What’s happening: The Department of Health Care Services (DHCS) is hosting hospitals and Medi-Cal managed care plans (MCPs) for a Value-Based Payment (VBP) Contracting Conference on Oct. 15 in Sacramento.
CHA Emphasizes Provider Perspectives at Latest Future of Medi-Cal Commission Advisory Group Meeting
What’s happening: The California Health Care Foundation’s Future of Medi-Cal Commission Advisory Group met last week, with discussion focused on implementing reforms well, strengthening accountability, simplifying Medi-Cal while protecting core benefits, and using data and technology to improve the member experience.
CHA, DHCS Still Awaiting Approval of Hospital Fee Program 9
What’s happening: On Aug. 14, CHA met with the Department of Health Care Services (DHCS) to discuss Hospital Fee Program 9 fee-for-service (FFS) approval, as well as an updated timeline for Program 10 resubmission.
DHCS Releases Private Hospital-Directed Payment Encounter Files
What’s happening: On July 31, the Department of Health Care Services (DHCS) uploaded two new hospital data sets that hospitals must download before the files are deleted on Sept. 14.
Hospitals’ High-Stakes Game — and What It Means for Patient Care
During last week’s CHA Board meeting, members were joined by Ken Kaufman, founder of the nationally renowned health care financial consulting firm Kaufman Hall, for a candid and enlightening conversation about the future of hospital care.
CMS Proposes Changes to Medicaid Provider Tax Rules
What's happening: The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule implementing the provider tax provisions included in the One Big Beautiful Bill Act (OBBBA), while also proposing additional policy changes that would strengthen federal oversight of Medicaid provider taxes.