About Legal, Regulatory, & Licensing
Navigating the vast network of health care laws, regulations, and licensing requirements is difficult. To help hospitals, CHA produces manuals and guidebooks, including the California Health Information Privacy Manual, which compares privacy requirements under HIPAA to state laws; the Model Medical Staff Bylaws and Rules, which outline the framework for working relationships among medical staff, hospital administrators and governing bodies; and the California Hospital Compliance Manual, which covers high-risk compliance issues. CHA also represents California hospitals’ interests in court on issues, including reimbursement, labor and employment, and more.
What’s Happening: The Centers for Medicare & Medicaid Services (CMS) has released resources on the newly finalized price transparency machine readable file (MRF) requirements.
What Else to Know: Hospitals have until July 1, 2024, to comply.
What’s Happening: A comprehensive summary of the finalized payment updates and policy changes to the Medicare outpatient prospective payment system for calendar year 2024 is available.
What Else to Know: The provisions are generally effective Jan. 1, 2024.
What’s happening: A members-only guide from the American Hospital Association to support hospitals in the implementation of the Medicare Advantage (MA) final rule is now available for calendar year 2024.
What else to know: The document provides a summary of key provisions of the final rule, which seeks to align MA coverage with traditional Medicare more clearly and to increase oversight of MA plans.
What’s happening: Dec. 8 is the deadline for hospitals to sign up for a CHA-supported legal challenge to Medicare’s low-wage index policy.
What else to know: An updated analysis increases the estimated impact of these policies on California hospitals from $26 million to $33 million in federal fiscal year (FFY) 2024.
What’s Happening: A DataGen webinar on Dec. 5 at noon (PT) will provide an overview of the calendar year 2024 outpatient prospective payment system final rule. What Else to Know: Registration is required.
What’s happening: A members-only summary from Health Policy Alternatives, Inc., of the proposed rule on information blocking details provider disincentives related to programs from the Centers for Medicare & Medicaid Services.
What else to know: Comments on the proposed rule are due Jan. 2.
What’s happening: Assembly Bill (AB) 1392 (2023) expands the Hospital Supplier Diversity program by requiring additional reporting information for hospitals, effective July 1, 2025.
What else to know: A fact sheet from the Department of Health Care Access and Information (HCAI) outlines the statutory changes and time frames for program implementation.
What’s happening: The Centers for Medicare & Medicaid Services’ (CMS) 2024 physician fee schedule final rule reduces Medicare payments to physicians by 1.23% compared to the prior year.
What else to know: The final 2024 physician fee schedule conversion factor is $32.74, a decrease of $1.15, or 3.4%, from 2023.