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.
FFY 2027 Readmissions Reduction Program Analysis
What’s happening: DataSuite has issued a hospital-specific analysis of the federal fiscal year (FFY) 2027 readmissions reduction program (RRP).
DHCS Requests Six-Month Delay in Medi-Cal Work Requirements Implementation
What’s happening: The California Department of Health Care Services (DHCS) has submitted a request to the Centers for Medicare & Medicaid Services (CMS) for a six-month good faith effort exemption from implementing Medi-Cal work and community engagement requirements, which are scheduled to take effect Jan. 1, 2027.
Revised Estimated Fee and Timing Payment Cycles for Program 9 Now Available
What’s happening: With the final components of Hospital Fee Program 9 (2025) expected to be approved in the coming weeks, CHA has released revised fee and payment timing estimates to assist hospitals in planning.
Analyses Available for IPPS Post-Acute Care Transfer Adjustment and CAH Value-Based Purchasing
What’s happening: DataSuite has issued two hospital-specific analyses for federal fiscal year (FFY) 2027:
Inpatient prospective payment system (IPPS) post-acute care transfer (PACT) adjustment policy
Medicare Critical Access Hospital (CAH) Value-Based Purchasing (VBP) program
CHA Finance and Reimbursement Conference Highlights State and Federal Policy Changes
What’s happening: Last week, CHA hosted a Finance and Reimbursement Conference, bringing together hospital finance leaders, policymakers and health care experts. The successful conference included discussion and insight into the federal/state landscape and the Office of Health Care Affordability (OHCA).
DHCS Responds to Latest CMS Questions on Program 9
What’s happening: With its response to a third round of questions on Hospital Fee Program 9 (2025) fee-for-service payments, the Department of Health Care Services (DHCS) has now addressed all inquiries from the Centers for Medicare & Medicaid Services (CMS).
DHCS Releases Private Hospital-Directed Payment Encounter Files
What’s happening: On Sept. 25, the Department of Health Care Services uploaded three new hospital data sets that hospitals must download before the files are deleted on Nov. 13.
2027 Nursing Facility Rates Available for Review and Comment
What's happening: The Department of Health Care Services (DHCS) has released the calendar year 2027 draft rates for Distinct Part Nursing Facilities, Level B, which are open for public comments until Oct. 16.
DHCS Implements Oct. 1 Eligibility Changes Required Under OBBBA
What's happening: On Oct. 1, the Department of Health Care Services (DHCS) implemented Medi-Cal eligibility changes required under the One Big Beautiful Bill Act.
Delay in CMS Approval of FFS Components Necessitates Revision of Program 9 Fee and Payment Timing
What’s happening: Since the final federal approvals on the Hospital Fee Program fee-for-service (FFS) components were not approved by the Centers for Medicare & Medicaid Services by Oct. 1, the fee and payment timing shared with hospitals in July will be revised.