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.
2026 Hospital Finance & Reimbursement Conference
October 19 & 20 | Sacramento As the health care landscape continues to evolve, hospital leaders face growing operational and regulatory challenges. Join CHA and finance executives from across California for an in-person conference examining the latest state and federal policy developments impacting hospitals today. Topics will include Medicare and Medi-Cal financing, state-directed payments, financial...
Summaries Detail Changes to Medicaid Payments, Work Requirements
What’s happening: CHA is sharing two analyses prepared by Health Policy Alternatives (HPA) that cover Medicaid rules on directed payments and targeted supplemental payments as well as the implementation of community engagement (work requirement) provisions.
Immediate Action Needed for Prescribers: Ensure Enrollment as Medi-Cal FFS Provider
What’s happening: Claims and prior authorizations will not be processed by Medi-Cal Rx if the prescribing health care provider is not enrolled in Medi-Cal fee-for-service (FFS) with a Type 1 National Provider Identifier. Prescribers not yet enrolled should immediately submit their Medi-Cal provider enrollment application via the Provider Application and Validation for Enrollment page.
Reminder: Include ICD-10-CM Diagnosis Codes on Medi-Cal Rx Claims
What’s happening: As a reminder, ICD-10-CM diagnosis codes will be required for Medi-Cal Rx claims starting this fall.
Fact Sheet: Medicaid in California
Medicaid in California
Medicaid is a lifeline to millions of Californians
Infographic: Protecting Access to Care for All Californians
DHCS’ Revised Prop. 35 Spending Plan Fails to Align with Voter Intent
What’s happening: At the May 28 “Protect Access to Health Care Act” Stakeholder Advisory Committee meeting, the Department of Health Care Services (DHCS) put forth a revised spending plan that fails to align funding with the intent of the voter-approved Proposition 35.
State Resubmits Hospital Fee Program 9, Draft Model Available for Members
What’s happening: On May 15, the state submitted the payment policies for the next iteration of the Hospital Fee Program (Program 9) to the Centers for Medicare & Medicaid Services (CMS). This is the final piece needed for CMS to review the full application.
Comments Due in July for CMS’ Medicaid Supplemental Payments Proposal
What's happening: Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule outlining changes to Medicaid supplemental payments, including managed care state-directed payments. This is some of the implementation rulemaking associated with the payment reductions Congress enacted in the One Big Beautiful Bill Act.
May Budget Revision Avoids Broad Health Care Cuts
What’s happening: Gov. Newsom’s May Revision to the proposed 2026-27 state budget reflects a stronger-than-expected revenue outlook that avoids broad cuts to health care while maintaining a cautious fiscal approach that includes significant changes to Medi-Cal coverage.