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.
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.
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.
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.
The Department of Managed Health Care (DMHC) has released draft guidance and accompanying forms — a confidentiality request form and an expedited exemption request form — related to its Knox-Keene licensure regulation.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.
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.
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.
Earlier this week, CHA attended a Senate Health Committee informational hearing that examined strategies across all purchasers and programs that have the objective of improving the care delivered to people with chronic conditions.
The Department of Health Care Services (DHCS) has released an update on the Health Homes Program, including current and future implementation counties, and counties where the program will not be implemented.
A CHA members-only webinar on Feb. 21 from 9:30-11 a.m. will provide information on recent changes to how Medi-Cal managed care plans can make supplemental payments through the Hospital Fee Program.
Later this year, the Department of Health Care Services (DHCS) will modify access to the Hospital Presumptive Eligibility (HPE) Application Portal. Providers who have not yet updated their HPE user information should do so to ensure they do not lose access to the portal.