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.
CHA Will Host 2024 Hospital Finance and Reimbursement Seminar
What’s happening: CHA will host a one-day seminar on March 11 (Sacramento) and 13 (Burbank) at 8 a.m. to discuss how Medicare, Medi-Cal, and other hospital reimbursements will be impacted by the state and federal regulatory environment, recently enacted and anticipated policies, and the new Office of Health Care Affordability (OHCA).
What else to know: The program will discuss key policies, challenges, and opportunities. Registration is open.
CMS Issues Advance Notice of Proposed Medicare Advantage Payment Changes
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued advance notice of proposed changes to Medicare Advantage (MA) Part C and Part D payments for calendar year 2025.
What else to know: Comments are due to CMS by 2 p.m. (PT) on March 1.
CHA DataSuite Releases Analysis of the Quality Program Measure Trends for Third Quarter 2023
What’s happening: CHA DataSuite issued a hospital-specific analysis for the quality program measure trends with an updated third quarter 2023 Care Compare data release.
What else to know: The measures updated in this release are hospital consumer assessments of health care providers and systems, safety, outcomes, readmissions, and star ratings. The Centers for Medicare & Medicaid Services adopted a sepsis measure to be evaluated under the federal fiscal year 2026 Value-Based Purchasing (VBP) Program, which is included in this analysis.
Vitality Payer Scorecard: Holding Insurers Accountable
CHA Continues Support for Medicaid DSH
What’s happening: Current funding legislation supported by CHA extends the delay in the implementation of pending Medicaid disproportionate share hospital cuts until March 8.
What else to know: On Jan. 18, the House and Senate passed legislation, known as a continuing resolution, to fund the federal government though March 1 for certain departments, and March 8 for others.
Real-Time Exchange of Electronic Health Records is Underway
What’s happening: Health care and social services organizations in California are required to share electronic health records as of Jan. 31 under the new Data Exchange Framework (DxF).
What else to know: Assembly Bill 133 (Statutes of 2021) outlined the requirement for health care providers, plans, and other entities to exchange health information for treatment, payment, or health care operations.
CHA Webinar to Explore OHCA’s Spending Target in Depth
This post has been archived and contains information that may be out of date.
What’s happening: CHA will host a complimentary, members-only webinar on Feb. 12 at 10 a.m. (PT) to discuss the Office of Health Care Affordability’s (OHCA) proposed 3% spending growth target for 2025-29.
What else to know: CHA staff will focus on what this proposal means, the detrimental impacts it would have on health care, and how hospitals can lend their voices to protect care. A 45-day public comment period on the proposed target ends March 11.
Office of Health Care Affordability (OHCA) – A Deep Dive on Spending Targets
Join CHA staff for a deeper look at what this proposal means, the detrimental impacts this will have on health care, and how hospitals can lend their voices to protect patient care.
House Ways and Means Committee Advances Bipartisan Tax Package
What’s happening: The House Ways and Means Committee voted 40-3 last week to advance the Tax Relief for American Families and Workers Act (TRAFWA) of 2024, which includes provisions that have bipartisan support.
What else to know: To pay for the package cost, the legislation accelerates the employee retention credit (ERC) claims submission deadline to Jan. 31. The ERC is a refundable tax credit for employers, including hospitals, who kept workers on their payrolls during the COVID-19 pandemic.
Congress Passes Legislation to Fund Government Through March
What’s happening: On Jan. 18, the House and Senate passed legislation, known as a continuing resolution, to fund the federal government though March 1 for certain departments and March 8 for others. President Joe Biden signed the bill on Jan. 19.
What else to know: The resolution included a CHA-supported provision to delay scheduled Medicaid disproportionate share hospital cuts until March 8.