Hospital Fee Program Status
The Hospital Quality Assurance Fee (HQAF) Program and all of its statutory provisions were made permanent through the passage of CHA’s ballot initiative, the Medi-Cal Funding and Accountability Act (Proposition 52), in the November 2016 general election. While this provides the framework for all future hospital fee programs, future iterations must adhere to federal regulations related to health-care provider taxes. Further, the Department of Health Care Services (DHCS) must obtain all necessary federal approvals.
Fee Program Proposal Submitted to CMS; Approval Typically Takes Up to Nine Months
Last week, and on schedule, the state Department of Health Care Services submitted the proposed model for the next iteration of the hospital fee program to the Centers for Medicare & Medicaid Services.
Hospital Fee Program 8 Invoices Due April 8
What’s happening: Payments for the Hospital Quality Assurance Fee program 8 directed payment are due to the Department of Health Care Services (DHCS) by April 8.
What else to know: Invoices were mailed to hospitals from DHCS on March 24. It is critical that all hospitals pay their invoices in full and on time. CHA encourages those at risk of not paying their invoices in full by April 8 to notify DHCS in advance of the due date about any financial hardship.
DHCS Submits Hospital Fee Program 9 Fee and Payment Model, Draft Available for Members
What’s happening: On March 28, the Department of Health Care Services (DHCS) submitted a final draft of the Hospital Quality Assurance Fee (HQAF) program 9 fee and payment model to the Centers for Medicare & Medicaid Services (CMS). An internal, members-only version is available for members to review.
What else to know: The model should be considered a draft until the state receives official CMS approval, which is expected to take six to nine months. Learn more about the 2025 HQAF program 9 — including a brief history, a summary of changes, and the future landscape of the program — in our members-only webinar on April 7 at 9 a.m. (PT).
Hospital Fee Program IX Webinar
The Department of Health Care Services (DHCS) recently submitted a final draft of the Hospital Fee Program (IX) fee and payment model to the Centers for Medicare & Medicaid Services (CMS). The model should be considered a draft until the state receives official CMS approval, which is expected to take four to six months. CHA will release […]
DHCS to Submit Hospital Fee Program 9 This Month
What’s happening: The Department of Health Care Services (DHCS) will submit the Hospital Quality Assurance Fee (HQAF) program 9 to the Centers for Medicare & Medicaid no later than March 31. Once submitted, CHA will share a draft model for member hospitals to review that will include internal calculations to assist in their review.
What else to know: Shortly after the approved model is released, CHA will host a webinar to provide historical HQAF program context and share the changes specific to program 9. CHA News will share updates and information on program 9’s status, as well as related educational opportunities, as they become available.
Hospital Fee Program Fees Due March 7
What’s happening: Hospital Quality Assurance Fee (HQAF) program 8 fees for the Jan. 1-June 30, 2023, managed care directed payment cycle are due March 7 — and the invoice will be 15% higher than the modeled fee amount.
What else to know: The fee is increased because the Department of Health Care Services (DHCS) is repaying the Centers for Medicare & Medicaid Services (CMS) for inpatient upper payment limit (UPL) overages incurred in HQAF program 6 — and CMS directed DHCS to repay immediately without any flexibility.
As 2024 Winds Down, Federal Advocacy Heats Up
As 2024 begins to come to a close, CHA’s advocacy attention will be focused on advancing priorities in Washington, D.C. We’ll be pushing to ensure federal approval for two critical state issues while also focusing on some key federal issues likely in play in the lame duck session.
Hospital Fee Program 9 (2024)
With each Hospital Fee Program renewal, DHCS retrieves the requisite hospital data and updates the fee and payment model as directed under the authorizing legislation found under state law (specifically, the Medi-Cal Hospital Reimbursement Improvement Act of 2013 codified at Welfare and Institutions Code sections 14169.50 through 14169.76).
Hospital Finance Week: Medi-Cal Updates/Hospital Fee Program
Get intel on the latest changes to the Hospital Fee Program and CHA’s perspective on recent Medi-Cal updates. Topics to be covered include: Review of the new Hospital Fee Program (Program 7) Medi-Cal Reform (CalAIM) Medi-Cal Managed Care Changes