About Medi-Cal
Every year, California’s hospitals treat millions of patients, many of them covered by Medi-Cal, the state’s health care safety net. This includes numerous essential health care services, including care for more than 50% of all births, 51% of behavioral health-related emergency department visits, and 49% of rural hospital patient care But for low-income Californians who rely on Medi-Cal for coverage — two-thirds of whom are people of color — their care is at serious risk. Communities with high Medi-Cal enrollment already suffer from a severe lack of health care providers and with hospital services at risk of being reduced and outright closures looming, California’s most vulnerable, including people living in rural and underserved areas, are in jeopardy.
Covered California Announces Preliminary Rates and Carriers for 2020
Covered California announced today that the preliminary average rate change for the 2020 individual market will be 0.8% — lower than the actual average increase over the past five years (7.9%), and the lowest rate change since Covered California first began offering coverage in 2014.
DMHC Releases Guidance on General Licensure Regulation
The Department of Managed Health Care (DMHC) has released final guidance on its Knox-Keene licensure regulation, which applies to any contract entered into, amended, or renewed on or after July 1. The regulation, among other things, defines various types of risk and requires entities that assume any amount of global risk to either obtain a license under the Knox-Keene Health Care Service Plan Act of 1975 or receive an exemption from DMHC.
DHCS Releases Access Assessment Draft, Comments Due June 28
The Department of Health Care Services (DHCS) has released a draft assessment of California health plans’ compliance with time/distance access standards for managed care patients. According to the assessment, only a small number of plans failed to meet these standards for at least 99% of enrollees.
CHA to Hold Member Forum on FFY 2020 IPPS Proposed Rule on June 11
CHA will host a member forum on June 11 at 10 a.m. (PT) to solicit member feedback on the federal fiscal year 2020 inpatient prospective payment system proposed rule issued by the Centers for Medicare & Medicaid Services (CMS).
Supreme Court Rejects Medicare Disproportionate Share Hospital Cuts
The Supreme Court ruled this week that the Department of Health and Human Services (HHS) violated the Medicare Act when, in 2014, it changed the calculation for payments to disproportionate share hospitals (DSH). The 7-1 court ruling could affect billions of dollars in Medicare payments to safety net hospitals.
DHCS Invites Hospitals to Participate in Medical Interpretation Services Survey
Tthe California Department of Health Care Services (DHCS) is conducting a study — as required by Assembly Bill 635 (Chapter 600, Statutes of 2016) — to identify current requirements for medical interpretation services. The findings will inform the department’s recommendations for future strategies related to medical interpretation services for Medi-Cal members with limited English proficiency.
More Than 300 Members of Congress Sign Bipartisan Letter Urging Delay of Medicaid DSH Cuts
A total of 302 members of Congress signed on to a bipartisan House letter urging Congress to delay cuts to Medicaid disproportionate share hospitals for at least two years. An overwhelming majority — 48 of 53 — of members of the California delegation cosigned the letter. CHA strongly supports this bipartisan effort and thanks members for their engagement on this critical issue.
May 20 Marks Comment Deadline for DMHC Draft Implementation Guidance on Licensure Regulation
The Department of Managed Health Care (DMHC) has released draft guidance and accompanying forms — a confidentiality request form and an expedited exemption request form — related to its Knox-Keene licensure regulation. The regulation, among other things, defines various types of risk and requires entities that assume any amount of global risk to either obtain a license under the Knox-Keene Health Care Service Plan Act of 1975 or receive an exemption from DMHC.
Medicare, Medicaid Commissions Issue 2019 Reports to Congress
Both the Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment and Access Commission (MACPAC) have issued their March 2019 reports to Congress, based on recommendations approved at their January meetings. The MedPAC report evaluates Medicare payment issues, while the MACPAC report recommends — among other items — that if planned Medicaid disproportionate share hospital (DSH) cuts proceed, they should be phased-in to give states and hospitals more time to respond.
DHCS to Hold Webinar on Proposed Value-Based Payment Program
On March 19 from 11 a.m. to noon, the Department of Health Care Services (DHCS) will hold a webinar on the Value-Based Payment (VBP) Program proposed in the governor’s fiscal year 2019-20 budget.