Legal, Regulatory, & Licensing

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.

CA Supreme Court to Address Whether Hospitals Must Disclose ER Visit Fees Before Treating Patient

For over a decade, at least 15 different class action lawsuits have been filed against California hospitals for failing to disclose their facility fees before patients were treated. The suits claim that hospitals failed to advise patients arriving at their emergency rooms that they would be charged an “evaluation and management services fee” (EMS fee), which violated the state’s unfair competition law (Bus. & Prof. Code § 17200 et seq.) and Consumers Legal Remedies Act (Civ. Code § 1750 et seq.).  

CMS Finalizes Policies on Medicare DSH Calculation

As part of the federal fiscal year 2024 inpatient prospective payment system final rule, the Centers for Medicare & Medicaid Services (CMS) also finalized its proposal to limit how Medicaid 1115 demonstration days count for purposes of the Medicare disproportionate share hospital (DSH) calculation.  

Explaining CMS’ 2024 OPPS and PFS Proposed Rules Webinar

On July 13, the Centers for Medicare & Medicaid Services (CMS) issued its calendar year (CY) 2024 outpatient prospective payment system (OPPS) proposed rule and physician fee schedule (PFS) proposed rule. CHA is hosting a members-only webinar to discuss key proposals in these proposed rules on August 21 from 9-10:30 a.m. (PT) ahead of the comment deadline.