Hospital Fee Program

CHA to Release 2019-21 Hospital Fee Program Pass-Through Schedules

On Feb. 5, CHA will distribute payment schedules to all Medi-Cal health plans and eligible hospitals for the 2019-21 Hospital Fee Program managed care pass-through cycle for July 1, 2019-Dec. 31, 2020. As previously shared in CHA News, these payment schedules will be associated with the fees collected by the Department of Health Care Service (DHCS) on Dec. 23, 2020, with a single invoice labeled as “MC1 PT” and “MC2 PT.”  

2019-21 Hospital Fee Program Invoices Due Oct. 14

Invoices for the 2019-21 Hospital Fee Program, fee-for-service cycle 4, were mailed on March 20; payments are due Oct. 14. The Department of Health Care Services (DHCS) prefers fee payments to be made via electronic funds transfer.   

CHA Provides Updates on 2019-21 Hospital Fee Program Payment Schedule

As previously shared in CHA News, following the Centers for Medicare & Medicaid Services (CMS) approval of the Hospital Fee Program, CHA distributes estimated fee and payment schedules to all hospitals. At the time of the 2019-21 approval in February, CHA and the Department of Health Care Services (DHCS) worked closely to finalize a payment schedule, which was distributed to hospitals in April. Since then, hospitals across the state have been preparing for and addressing the COVID-19 pandemic.  

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. 

Hospital Fee Program Invoices Due Aug. 20

On Friday, the Department of Health Care Services (DHCS) mailed the 2017-19 Hospital Fee Program managed care state fiscal year 2018-19 directed payment invoices (July 1-Dec. 31, 2018). Hospitals are reminded that payment is due Aug. 20 and that DHCS prefers fee payments to be made via electronic funds transfer. 

DHCS Extends Deadline for Hospital-Directed Contract Status File

As previously reported in CHA News, the Department of Health Care Services (DHCS) last month released the fiscal year 2018-19 Phase 2 encounter data files for hospitals and health plans to begin reconciling the contract status. These encounter files will be used in the calculations for the Hospital Fee Program managed care directed payments. DHCS has announced it will extend the deadline for hospitals and health plans to submit reconciled files from July 17 to July 31.