More than 15 million Californians rely on Medi-Cal, the state’s health care coverage safety net, for health insurance. Two-thirds of those on Medi-Cal are people of color and often live in communities with a lack of adequate health care providers. Without significant investments to support providers that deliver health care to California’s most vulnerable, millions living in rural and underserved areas are in jeopardy.
On May 2, the Department of Health Care Services (DHCS) sent payment and utilization data to hospitals that have been determined eligible for payments under the disproportionate share hospital (DSH) and DSH replacement programs for fiscal year 2021-22.
The Centers for Medicare & Medicaid Services (CMS) has issued a rule finalizing policies for contract year 2023 Medicare Advantage (MA) and Medicare prescription drug benefit programs. The rule finalizes proposals on increased agency oversight of plan marketing, expansion and network adequacy, reinstatement of medical loss ratio reporting requirements, and equity-oriented changes to dual-eligible special […]
The Centers for Medicare & Medicaid Services (CMS) has issued its federal fiscal year (FFY) 2023 inpatient prospective payment system (IPPS) proposed rule. Comments on the proposed rule are due to CMS by June 17.
On April 11, the Department of Health Care Services (DHCS) Capitated Rate Development Division notified hospitals that due to a system issue, Partnership Health Plan has had challenges in completing its reporting to identify contracted status for Medi-Cal Hospital Directed Payment Programs.
Beginning May 1, California will provide full-scope Medi-Cal benefits to individuals who are age 50 or older, regardless of citizenship or immigration status, who meet all other Medi-Cal full-scope eligibility criteria.
On April 6, the Department of Health Care Services updated its state fiscal year (SFY) 2021-22 Diagnosis-Related Group grouper settings documents to reflect 3M Grouper Software mapper and hospital-acquired conditions updates that took effect on April 1.