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 to Host FFY 2025 IPPS Proposed Rule Webinar
What’s happening: CHA will host a complimentary, members-only webinar on May 15 at 9:30 a.m. (PT) to discuss the federal fiscal year (FFY) 2025 inpatient prospective payment system (IPPS) proposed rule. Registration is open.
What else to know: Comments on the proposed rule are due to the Centers for Medicare & Medicaid Services by June 10.
CMS Finalizes Rule on Access to Medicaid Services
What’s happening: The Centers for Medicare & Medicaid Services (CMS) finalized a rule meant to improve access to care and services for the people enrolled in the Medicaid program.
What else to know: The rule is effective July 9.
CHA DataSuite Analyzes FFY 2025 Medicare Skilled-Nursing Facility Proposed Rule
What’s happening: CHA DataSuite issued a hospital-specific analysis of the federal fiscal year (FFY) 2025 Medicare skilled-nursing facility prospective payment system proposed rule analysis.
What else to know: The analysis is intended to show hospitals how Medicare fee-for-service payments would change from FFY 2024 to FFY 2025 based on the policies set forth in the proposed rule.
CHA Will Host Webinar on Mandatory Bundled Payment Model
What’s happening: CHA will host a complimentary, members-only webinar on May 1 at noon (PT) to discuss the mandatory bundled payment model proposed by the Centers for Medicare & Medicaid Services (CMS). Registration is open.
What else to know: CMS proposed the Transforming Episode Accountability Model (TEAM), which will hold selected hospitals accountable for the cost and quality of certain surgical procedures.
CMS Finalizes Medicaid Managed Care Rule on Access, Finance, and Quality
What’s happening: The Centers for Medicare & Medicaid Services (CMS) finalized the Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality rule.
What else to know: The rule finalizes significant changes and clarifications regarding managed care delivery and finance.
Hospital Leaders Discuss Financial Challenges with Legislators on Capitol Hill
What’s happening: Last week, California hospital and health system leaders convened in Washington, D.C. for the American Hospital Association (AHA) Annual Membership Meeting.
What else to know: Hospital and health system leaders participated in meetings on Capitol Hill with the California congressional delegation to advance CHA’s position on key advocacy priorities.
CHA DataSuite Releases FFY 2025 Medicare Inpatient Rehabilitation Facility Proposed Rule Analysis
What’s happening: CHA DataSuite issued a hospital-specific analysis of the federal fiscal year (FFY) 2025 Medicare inpatient rehabilitation facility proposed rule analysis.
What else to know: The analysis is intended to show hospitals how Medicare fee-for-service payments would change from FFY 2024 to FFY 2025 based on the policies set forth in the proposed rule.
HRSA Implements Long-Awaited Dispute Resolution Process
What’s happening: The Health Resources and Services Administration (HRSA) finalized requirements and procedures for the 340B Drug Discount Program’s administrative dispute resolution (ADR) process.
What else to know: The regulation is effective June 18.
Summary: FFY 2025 Inpatient Psychiatric Facility Medicare Payment Proposed Rule
What’s happening: A summary of the inpatient psychiatric facility (IPF) prospective payment system (PPS) proposed rule is available.
What else to know: Comments on the proposed rule are due by May 28.
FFY 2025 IPPS Proposed Rule Webinar
Join CHA’s Megan Howard and Chad Mulvany as they provide a summary of the proposed rule implications on your organization and how you can share your concerns on the impending changes.