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.
Hospital Fee Program 9 Payment Policies Likely to Be Finalized in Early May
What’s happening: The California Department of Health Care Services (DHCS) has indicated that payment policies are likely to be finalized in early May for the revised Hospital Fee Program tax model for calendar year 2025 (Program 9), which was submitted to the Centers for Medicare & Medicaid Services (CMS) last month. Soon after finalization, a model will be...
CHA’s Two Sponsored Bills Make It Out of Assembly Health Committee
What’s happening: Despite the concerns of Chair Mia Bonta, both CHA-sponsored bills —Assembly Bill (AB) 1923 (Soria, D-Merced) and AB 2353 (Pacheco, D-Downey) — moved out of the Assembly Health Committee on Tuesday. AB 1923 would expand the Distressed Hospital Loan Program (DHLP) and AB 2353 would allow for additional cost analysis of proposed legislation and regulations...
CHA Warns of Growing Financial Strain on Hospitals at Budget Subcommittee Hearing
What’s happening: On April 6, the Assembly Budget Subcommittee on Health held a hearing to continue its overview of the state’s budget condition and impacts of the One Big Beautiful Bill Act (OBBBA).
CHA Alert: Urge Lawmakers to Support Funding for Distressed Hospital Loan Program
What’s happening: Yesterday, CHA issued an alert asking members to write to the Senate and Assembly budget committee chairs and support the request for a one-time appropriation of $300 million for the Distressed Hospital Loan Program, as well as statutory changes to advance the program.
DHCS Issues RFI to Shape Comprehensive Hospital Value Strategy
What’s happening: The Department of Health Care Services (DHCS) has issued a request for information that seeks to collect input from stakeholders and shape DHCS’ comprehensive “Hospital Value Strategy.” The RFI deadline is April 17.
Medicaid State-Directed Payments Help Ensure Patient Access to Care
About State-Directed Payments (SDPs) SDPs are additional payments made to health care providers to support Medicaid quality and access goals. The Centers for Medicare & Medicaid Services (CMS) reviews and approves SDPs for each 12-month rating period. Payments to providers are made via managed care organizations (MCOs) and are based on utilization of Medicaid services....
Medicaid Provider Taxes Protect Californians’ Access to Care
Medicaid provider taxes are a cornerstone of the Medicaid financing structure. Without federal revenue generated from these taxes, reimbursement for care provided to patients covered by Medicaid would be woefully insufficient and health care access would be at grave risk. For many hospitals, losing this revenue would mean closure of service lines; for others, it...
Medicare IRF Review Choice Demonstration – What You Need to Know
The Centers for Medicare & Medicaid Services (CMS) is expanding the Review Choice Demonstration (RCD) for Inpatient Rehabilitation Facility (IRF) Services to California, forcing all California IRFs to choose between either 100% pre-claim review or 100% post-payment review. That decision must be made by April 14.
Issue Brief: Time Is Running Short to Save Hospitals, Preserve Access to Health Care
Medicare and Medi-Cal underfunding have put the health care system on the precipice.
Key Messages: California’s Health Care System Is on Life Support
The risk of losing access to critical health care services for Californians has never been greater.