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.
Medi-Cal Rx Claims to Require ICD-10-CM Diagnosis Codes Beginning This Fall
What’s happening: Starting this fall, ICD-10-CM diagnosis code(s) will be required for Medi-Cal Rx claims. This change is being made to better implement appropriate utilization management controls, including prior authorization.
CHA Alert Reminder: Act Now to Support Distressed Hospital Loan Program
What’s happening: On Monday, CHA issued an alert reminder, 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.
Rounding the First Turn in the Legislative Session
A critical deadline passed last week in the state Legislature and there’s good news: both of CHA’s sponsored bills — one that would expand and reinvest in the Distressed Hospital Loan Program and another that would cost out proposed laws — have passed out of their committees.
Assembly Budget Subcommittee on Health Gets Update on DHLP, Rural Health Transformation Program
What’s happening: The Assembly Budget Subcommittee on Health met this week to receive an update from the Department of Health Care Access and Information (HCAI) on the Distressed Hospital Loan Program (DHLP), as well as implementation of the Rural Health Transformation Program (RHTP).
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.
State Submits Hospital Fee Program 10 to CMS
What’s happening: Last week, the California Department of Health Care Services (DHCS) submitted its Hospital Fee Program tax model for calendar year 2026 (Program 10) to the Centers for Medicare & Medicaid Services (CMS).