About Finance & Reimbursement
California’s hospitals are under duress, facing crippling inflation and systemic underfunding by government payers — Medi-Cal and Medicare. Every day, over half of California’s hospitals lose money caring for patients. The 2023-24 state budget reauthorizes California’s managed care organization tax, dedicating much of the revenue to support for Medi-Cal enrollees. But without meaningful change to Medicare and Medi-Cal, the most vulnerable Californians will continue to be left behind. Health insurance companies must also do their part to protect essential services, including timely reimbursement and processing of claims. reimbursement and processing of claims.
AHA to Host Annual Meeting April 14-16 in Washington, D.C.
What’s happening: Hospital leaders from around the country will convene in Washington, D.C. on April 14-16 for the American Hospital Association’s (AHA) Annual Membership Meeting.
What else to know: CHA encourages AHA members to register for this event.
President Biden Releases FY 2025 Budget Request
What’s happening: President Biden submitted his fiscal year (FY) 2025 budget request to Congress.
What else to know: The budget is a blueprint of the administration’s priorities and is not legislation.
Payment Program Announced for Providers Affected by Change Healthcare Cyberattack
What’s happening: The Centers for Medicare & Medicaid Services (CMS) provided details on Medicare advance and accelerated payments for providers affected by the Change Healthcare cyberattack.
What else to know: Impacted hospitals should apply through their Medicare administrative contractor (MAC).
DMHC Complaint and Appeals Process Webinar
House Passes First Package to Fund Federal Government, Includes Health Provisions
What’s happening: The U.S. House passed the Consolidated Appropriations Act of 2024, which will fund a portion of the federal government through the end of the fiscal year. The package includes a group of CHA-supported health care provisions important to hospitals.
What else to know: Congress has until March 22 to pass a second package to fund the rest of the federal government, including the Department of Health and Human Services.
CHA Encourages Members to Participate in the Vitality Index Payer Scorecard
What’s happening: CHA is endorsing member participation in the Vitality Index Payer Scorecard, which will provide critical information to support CHA’s advocacy to hold insurers accountable for timely and accurate reimbursement.
What else to know: The CHA Board of Trustees has endorsed this tool, which will automatically draw de-identified claims and remittance information from hospitals without requiring additional reporting or surveys.
CMS Announces Flexibilities for Providers Impacted by Change Healthcare Hack
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued a statement outlining the flexibilities it is offering to providers impacted by the Change Healthcare data breach.
What else to know: CHA is closely following this issue and will provide updates on additional steps CMS is taking as they become available.
CMS Releases Data on No Surprises Act Payment Disputes
What’s happening: The Centers for Medicare & Medicaid Services released publicly available independent dispute resolution (IDR) reports for the first two quarters of reporting year 2023.
What else to know: The report includes certain data submitted by disputing parties and certified IDR entities to the No Surprises Act (NSA) federal IDR portal.
CMS Finalizes Medicaid DSH Third-Party Payment Calculation
What’s happening: The Centers for Medicare & Medicaid Services finalized changes to how states calculate the hospital-specific cap for Medicaid disproportionate share hospitals (DSH).
What else to know: The rule is effective April 23.
CHA Provides Updated Federal Quality Measures Matrix
What’s happening: CHA has updated its federal quality measures matrix to reflect the 2024 federal fiscal year and calendar year Medicare prospective payment system final rules.
What else to know: The matrix includes quality measures required for public reporting and performance-based programs for hospitals and post-acute care providers.