Finance & Reimbursement

About Finance & Reimbursement

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.  

HHS Announces Additional Block Grants to Address Substance Use Disorder and Mental Health Crisis

The U.S. Department of Health and Human Services has announced the Substance Abuse and Mental Health Services Administration is distributing $3 billion in American Rescue Plan funding. The Community Mental Health Services Block Grant (MHBG) program and Substance Abuse Prevention and Treatment Block Grant (SABG) program will disperse $1.5 billion each to states and territories.  

HRSA Orders Drug Companies to Resume Discounts to 340B Contract Pharmacies

The Health Resources & Services Administration (HRSA) ordered six pharmaceutical companies to resume payments to contract pharmacies participating in the 340B discount program, stating that their current policies have resulted in overcharges and are in direct violation of the 340B statute. The letters were sent to Eli Lilly, Sanofi, AstraZeneca, Novartis, United Therapeutics, and Novo Nordisk. 

Governor Releases Revised State Budget

On May 14, Gov. Newsom presented the Legislature with revisions to the budget he proposed in January, the process referred to as the May Revise. Throughout the week leading up to the release of the revision, the governor had been presenting various proposals as part of his “California Roars Back” plan, touted as a recovery package tackling the […]

CHA Urges Hospitals to Review Wage Data by May 28

CHA urges hospitals to review their wage and occupational mix data public use files (PUFs), issued by the Centers for Medicare & Medicaid Services (CMS), by May 28. These files are used to develop the hospital wage index for federal fiscal year (FFY) 2022.  

DRG Program Payment System Update Includes ICD-10 Procedure and Diagnosis Codes

The Diagnosis Related Group (DRG) Program payment system has been updated to include the ICD-10 procedure and diagnosis codes released by Centers for Medicare & Medicaid Services on Jan. 1.   Providers receiving a DRG inpatient hospital claim denial with RAD code 9124 (diagnosis code missing or invalid) may void and resubmit claims for payment. Email [email protected] with any DRG questions.