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.
Hospitals Must Complete Occupational Mix Survey by June 30
What’s happening: Hospitals are required to complete the new occupational mix survey for the federal fiscal year (FFY) 2028 wage index and submit it to their Medicare Administrative Contractor by June 30.
Two Hospital-Specific Quality Analyses Available from CHA DataSuite
What’s happening: CHA DataSuite has issued hospital-specific analyses of the Value-Based Purchasing (VBP) Program and the Hospital-Acquired Condition (HAC) Reduction Program for federal fiscal year (FFY) 2027.
2026 Hospital Finance & Reimbursement Conference
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 regulations, the Office of Health Care […]
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.