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 DataSuite Releases Analysis of FFY 2020 HAC Reduction Program, Medicare Inpatient Psychiatric Facility Final Rule
CHA DataSuite has issued hospital-specific analyses of the federal fiscal year (FFY) 2020 Hospital-Acquired Condition (HAC) Reduction Program and Medicare inpatient psychiatric facility (IPF) final rule.
CHA DataSuite Releases Analyses of 2020 Long-Term Care and Skilled-Nursing Facility Final Rules
CHA DataSuite has issued two hospital-specific analyses — one detailing the Centers for Medicare & Services (CMS) federal fiscal year (FFY) 2020 long-term care hospital (LTCH) prospective payment system (PPS) final rule, and the other detailing FFY 2020 Medicare skilled-nursing facility PPS final rule.
CHA Comments on Calendar Year 2020 Home Health Proposed Rule
CHA submitted comments on the Centers for Medicare & Medicaid Services’ (CMS) calendar year proposed rule for the home health (HH) prospective payment system.
CHA Issues Summary of FFY 2020 Inpatient Psychiatric Facility PPS Final Rule
CHA has issued a summary, prepared by DataGen, Inc., of the Centers for Medicare & Medicaid Services’ (CMS) final rule addressing rate updates and policy changes to the Medicare inpatient psychiatric facilities prospective payment system for federal fiscal year (FFY) 2020.
CHA DataSuite Releases Analysis of Inpatient Prospective Payment System FFY 2020 Final Rule
CHA has provided member hospitals and health systems with hospital-specific CHA DataSuite analyses showing how Medicare inpatient fee-for-service (FFS) payments will change from federal fiscal year (FFY) 2019 to 2020 based on policies in the Centers for Medicare & Medicaid Services’ (CMS) FFY 2020 inpatient prospective payment system (IPPS) final rule.
CHA Issues CY 2020 Outpatient Prospect Payment System Proposed Rule Summary — Register for Member Forum
CHA has issued a summary of the Centers for Medicare & Medicaid Services’ (CMS) calendar year (CY) 2020 outpatient prospective payment system (OPPS) proposed rule. In addition, CHA will host a member forum on Sept. 11 at 1 p.m. (PT) to review several key provisions outlined below and to solicit member input for draft comments. Register for the forum by noon (PT) on Sept. 10.
CHA Issues Summaries of Post-Acute Prospective Payment System Final Rules
CHA has issued summaries, prepared by Health Policy Alternatives, of the final rules for the inpatient rehabilitation facility, skilled-nursing facility and long-term care hospital prospective payment systems for federal fiscal year 2020.
CHA DataSuite Analyses Released: Home Health CY 2020 Proposed Rule, Inpatient Rehabilitation Facility FFY 2020 Final Rule
CHA DataSuite has issued two hospital-specific analyses, one detailing the Centers for Medicare & Medicaid Services (CMS) calendar year 2020 Medicare home health prospective payment system (PPS) proposed rule, and the other detailing federal fiscal year 2020 Medicare inpatient rehabilitation facility (IRF) PPS final rule.
CHA DataSuite Issues Summary Analysis of Calendar Year 2020 Outpatient PPS Proposed Rule
CHA DataSuite has issued a hospital-specific analysis detailing the Centers for Medicare & Medicaid Services (CMS) calendar year (CY) 2020 outpatient prospective payment system (OPPS) proposed rule. The analysis is intended to show providers how Medicare outpatient fee-for-service payments may change from CY 2019 to CY 2020 based on the policies set forth in the CY 2020 OPPS proposed rule, using the FFY 2020 inpatient prospective payment system final rule wage index.
CMS Issues Calendar Year 2020 ESRD/DMEPOS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) has issued its proposed rule revising the end-stage renal disease (ESRD) prospective payment system (PPS) and policies related to durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for calendar year (CY) 2020. CHA has made available a detailed summary of the proposed rule, prepared by Health Policy Alternatives. Comments on the proposed rule are due Sept. 27.