About Medi-Cal
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.
DHCS Sends FY 2021-22 Disproportionate Share Hospital Data to Hospitals for Data Correction Period
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.
CMS Finalizes Contract Year 2023 Medicare Advantage and Part D Plans Rule
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 […]
CHA Provides Additional Details on FFY 2023 IPPS Proposed Rule
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.
Abundance of Revenue May Trigger State Spending Limits
Even though the state will bring in billions of dollars in surplus revenue this year, its ability to spend those additional dollars may be more limited than it has been for many years. This unique challenge facing the Legislature and administration as they craft the 2022-23 state budget is being driven by a voter-approved requirement in the state Constitution.
CHA Responds to Request for Information on Medicaid and CHIP Access
On April 18, CHA submitted responses to a Centers for Medicare & Medicaid Services request for information on improving access to care and coverage for individuals enrolled in Medicaid and the Children’s Health Insurance Program.
DHCS Extends PHDP Contract Status Deadline for Partnership Health Plan
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.
Medi-Cal Older Adult Expansion Takes Effect on May 1
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.
DHCS Releases Diagnosis-Related Group 2021-22 Grouper Setting Updates
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.
The Middle Innings of the Legislative Cycle
If California’s legislative session — which runs from January through the end of September — can be looked at as a nine-inning baseball game, we’re just weeks away from the middle three innings. That means legislative priorities are coming into sharper focus and strategy is beginning to turn to tactics.
Same State, Different Worlds
There are two Californias when it comes to health care. In one, patients and communities are well-served by their health care system. Physicians, nurses, pharmacists, and other providers are easily accessible, offer a wide variety of services at multiple locations, and deliver care using the latest technology. In the other, care sites are harder to […]