Finance & Reimbursement

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.

CHA DataSuite CY 2025 HH Final Rule Impact Analysis Shows How Medicare FFS Payments Will Change

What’s happening: CHA DataSuite has issued a hospital-specific analysis of the calendar year (CY) 2025 Medicare home health (HH) prospective payment system final rule analysis.  

What else to know: The analysis is intended to show HH providers how Medicare fee-for-service (FFS) payments will change from CY 2024 to CY 2025 based on the policies set forth in the final rule. A detailed summary of the final rule is available for CHA members. 

As 2024 Winds Down, Federal Advocacy Heats Up

As 2024 begins to come to a close, CHA’s advocacy attention will be focused on advancing priorities in Washington, D.C. We’ll be pushing to ensure federal approval for two critical state issues while also focusing on some key federal issues likely in play in the lame duck session. 

CHA Supports Eliminating Low Wage Index Hospital Policy for FFY 2025

What’s happening: CHA submitted comments in support of an interim final rule that eliminates the low wage index policy and associated budget neutrality adjustment for federal fiscal year (FFY) 2025.  

What else to know: The rule was issued by the Centers for Medicare & Medicaid Services (CMS) in response to the U.S. Court of Appeals for the District of Columbia Circuit (D.C. Circuit) decision in Bridgeport Hospital, et al., v. Becerra. 

HQI Virtual Forum to Discuss Workplace Violence in Rural, Critical Access Hospitals

What’s happening: Individuals leading and supporting hospital efforts to eliminate workplace violence are invited to the next Hospital Quality Institute (HQI) virtual forum on Dec. 12 at noon (PT).  

What else to know: The forum will discuss workplace violence concerns and interventions specific to critical access and rural hospitals. Registration is open, and participation is free for all CHA and HQI member hospitals.    

Hospital Fee Program 9 (2024)

With each Hospital Fee Program renewal, DHCS retrieves the requisite hospital data and updates the fee and payment model as directed under the authorizing legislation found under state law (specifically, the Medi-Cal Hospital Reimbursement Improvement Act of 2013 codified at Welfare and Institutions Code sections 14169.50 through 14169.76).

Letter Highlights Challenges CA Hospitals Face Receiving COVID-19 Relief Funds

What’s happening: On Nov. 18, CHA sent a letter to the California congressional delegation about outstanding COVID-19 relief funds owed to California hospitals and the challenges they have had getting funds obligated from the Federal Emergency Management Agency (FEMA). 

What else to know: Also on Nov. 18, President Joe Biden sent Congress a $100 billion emergency supplemental funding request, which includes money for FEMA’s Disaster Relief Fund and called on members to approve the package for recent and past disasters.  

CHA Outlines Year-End Federal Legislative Health Care Priorities

What’s happening: In a Nov. 18 letter to the California congressional delegation, CHA outlined legislative priorities for the remainder of the 118th Congress — which must act by Dec. 20 to fund the federal government.  

What else to know: It is likely that some health care extensions and policies could be a part of Congress’ funding package. 

2025 ESRD PPS Final Rule Members-Only Summary Available Now

What’s happening: A members-only summary of the Centers for Medicare & Medicaid Services’ calendar year (CY) 2025 end-stage renal disease (ESRD) prospective payment system (PPS) final rule, prepared by Health Policy Alternatives, Inc., is available.   

What else to know: The regulation is effective Jan. 1, 2025.