About Finance & Reimbursement
The COVID-19 pandemic has decimated California’s hospitals, leaving more than half losing money every day to care for patients. While hospitals strive to contain costs as they deliver essential care to their communities, the simple fact is that the cost to provide care is outpacing reimbursement for those services. Without meaningful change within the Medicare and Medi-Cal systems, the most vulnerable Californians will continue to be relegated to a second-class health care system. Health insurance companies must also do their part to protect essential services, including timely reimbursement and processing of patient claims.
The Centers for Medicare & Medicaid Services has issued new guidance on the enrollment and conversion process for rural emergency hospitals (REHs), FAQs, and a newly developed State Operations Manual Appendix (Appendix O) with survey procedures. Interpretive guidelines for REHs are still pending and will be released at a future date. The state of California […]
CHA will host a Feb. 3 webinar on changes to Medi-Cal long-term care (LTC), which is being standardized across the state under California Advancing and Innovating Medi-Cal. Effective Jan. 1, all managed care plans must authorize and cover medically necessary LTC services at skilled-nursing facilities (SNFs). During the webinar, the Department of Health Care Services […]
CHA has issued members-only draft comments on the proposed rule updating the 340B administrative dispute resolution (ADR) process.
The Federal Emergency Management Agency (FEMA) has issued an updated policy that simplifies procedures and documentation requirements for the public assistance (PA) program to support rapid recovery for applicants.
Join Amanda Hayes-Kibreab, partner at Kings-Spalding, as she shares insights on the No Surprises Act.
The Centers for Medicare & Medicaid Services (CMS) has announced that more than 700,000 health care providers and organizations are participating in at least one of three accountable care models in 2023.
On Jan. 10, the U. S. District Court for the District of Columbia sent a case about 340B underpayments back to the Department of Health and Human Services (HHS).
To increase access to comprehensive care coordination, care management, and a broad array of services for Medi-Cal beneficiaries, CalAIM is standardizing Medi-Cal Long-Term Care (LTC) across the state. Effective January 1, all managed care plans must authorize and cover medically necessary LTC services at Skilled Nursing Facilities.
CHA has issued a members-only summary, prepared by Health Policy Alternatives, Inc., of the proposed changes to Medicare Advantage (MA) and Part D programs for contract year 2024.
CHA is reminding members of the upcoming deadline for the American Rescue Plan (ARP) Rural Fund and that Provider Relief Fund (PRF) Reporting Period 4 is now open. Phase 4 PRF/ARP Rural Funds Reconsideration Process Deadline: Hospitals that believe their Phase 4 PRF or ARP Rural Funds were inaccurately calculated have until Feb. 21, 2023, […]