Hospital Fee Program

About Hospital Fee Program

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. View the hospital fee program federal approvals received to date, for the programs beginning on or after January 2014.

Eyes on CMS as Fee Program Negotiations Continue

As California hospitals continue to face strong financial headwinds — soaring inflation, the pending effects of nearly $1 trillion in nationwide federal health care cuts, increased regulatory pressures, and more — all eyes are on the Centers for Medicare & Medicaid Services (CMS), where California’s submission for the next Hospital Fee Program is currently under review.

CMS Issues Preliminary Guidance on Provider Taxes

What’s happening: On Nov. 14, the Centers for Medicare & Medicaid Services (CMS) issued preliminary guidance on new federal requirements for Medicaid health care-related taxes (i.e., provider taxes) included in the One Big Beautiful Bill Act (OBBBA). 

CHA Requests Feedback on Hospital Fee Program 10 Proposed Data by Nov. 25

What’s happening: CHA has been working closely with the Department of Health Care Services (DHCS) to develop Hospital Fee Program 10 — a one-year program that would utilize 2023 data and start on Jan. 1, 2026. 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...