Even before the COVID-19 pandemic, many California hospitals’ financial situations were challenging — nearly 40% operated in the red. Hospitals strive to contain costs while delivering essential care to their communities in the most cost-effective manner. CHA provides direction to hospitals on the diverse issues that affect their financial performance, and advocates for them to ensure that much-needed programs retain their funding. In addition, CHA offers tools such as DataSuite to help hospitals analyze government reimbursement changes, and the potential impact of regulatory and legislative actions on hospitals.
About Finance & Reimbursement
CHA has issued a members-only copy of draft comments on the federal fiscal year (FFY) 2022 inpatient prospective payment system (IPPS) proposed rule.
On June 11, the U.S. Department of Health and Human Services released updated Provider Relief Fund (PRF) reporting requirements. As requested by CHA and others, the revised guidance extends the time granted to recipients to use the funds. CHA developed an updated overview of the PRF requirements.
The Medicare Payment Advisory Commission (MedPAC) has released its June 2021 Report to the Congress, a mandated report that details analysis and recommendations about the Medicare program and health care delivery system.
The Department of Health & Human Services (HHS) has issued a proposed rule to rescind a Trump-era final rule requiring federally qualified health centers to fully pass along discounts they received from the 340B drug discount program for insulin and EpiPens to low-income or uninsured patients.
On June 11, the U.S. Department of Health and Human Services (HHS) released updated Provider Relief Fund (PRF) reporting requirements. As requested by CHA and others, the revised guidance extends the time granted to recipients to use the funds. The table below illustrates that the time frame for using and reporting PRFs will now occur on a rolling basis based on when the funds were received.
On June 9, CHA issued an alert asking hospitals to urge their U.S. senators and representatives to support bipartisan legislation that preserves program eligibility for certain 340B hospitals during the COVID-19 public health emergency.
CHA DataSuite has issued two hospital-specific analyses for hospitals. The first analysis is of the Medicare hospital federal fiscal year (FFY) 2023 preliminary wage index and occupational mix data — which is designed in the Information Builders (IB) platform — and a second analysis covers the first quarter of 2021 quality program measure designed in the IB platform.
The Centers for Medicare & Medicaid Services (CMS) has announced an additional payment amount for administering in-home COVID-19 vaccinations to homebound Medicare beneficiaries.
Providers may request an interim reconciliation report from Noridian Healthcare Solutions, the Medicare administrative contractor (MAC) for California, that summarizes the amount of Medicare Advanced and Accelerated Payment (MAAP) repayments recouped compared to the amounts still outstanding.
On June 17 from 3 to 4 p.m. (PT), CHA will host a member forum to present an overview of the draft request for proposal for the Medi-Cal managed care plan (MCP) contract and the upcoming Medi-Cal MCP procurement that was released by the Department of Health Care Services on June 1. Ryan Witz, CHA vice president of health care […]