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.
President Biden Releases FY 2025 Budget Request
What’s happening: President Biden submitted his fiscal year (FY) 2025 budget request to Congress.
What else to know: The budget is a blueprint of the administration’s priorities and is not legislation.
House Passes First Package to Fund Federal Government, Includes Health Provisions
What’s happening: The U.S. House passed the Consolidated Appropriations Act of 2024, which will fund a portion of the federal government through the end of the fiscal year. The package includes a group of CHA-supported health care provisions important to hospitals.
What else to know: Congress has until March 22 to pass a second package to fund the rest of the federal government, including the Department of Health and Human Services.
DHCS Releases Distinct-Part Nursing and Subacute Rates
What’s happening: Last week, the California Department of Health Care Services (DHCS) posted updated payment rates for distinct-part nursing facilities (DP-NF) and distinct-part subacute facilities (DP-SA) for adults and pediatrics.
What else to know: Now that DP-NF and DP-SA services have been fully carved into Medi-Cal managed care plans’ (MCPs) scope of benefits, DHCS has implemented a policy that transitions the DP-NF and DP-SA rate year to a calendar year to align with the Medi-Cal managed care rate year.
DHCS Issues Private Hospital Supplemental Funds Round B Payments
What’s happening: Over the past two weeks, the Department of Health Care Services (DHCS) issued Private Hospital Supplemental Fund Round B payments to hospitals eligible for the program in fiscal year 2023-24.
What else to know: This round of payments to the approximately 90 eligible hospitals totaled roughly $60 million.
CMS Approves Calendar Year 2022 Medi-Cal Managed Care Rates
What’s happening: On Feb. 22, the Centers for Medicare & Medicaid Services approved the Medi-Cal managed care rates for the rating period from Jan. 1, 2022, to Dec. 31, 2022.
What else to know: Copies of the federal approval letters are available on CHA’s Hospital Fee Program web page under Program 7.
CHA Encourages Members to Participate in the Vitality Index Payer Scorecard
What’s happening: CHA is endorsing member participation in the Vitality Index Payer Scorecard, which will provide critical information to support CHA’s advocacy to hold insurers accountable for timely and accurate reimbursement.
What else to know: The CHA Board of Trustees has endorsed this tool, which will automatically draw de-identified claims and remittance information from hospitals without requiring additional reporting or surveys.
CMS Announces Flexibilities for Providers Impacted by Change Healthcare Hack
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued a statement outlining the flexibilities it is offering to providers impacted by the Change Healthcare data breach.
What else to know: CHA is closely following this issue and will provide updates on additional steps CMS is taking as they become available.
CMS Finalizes Medicaid DSH Third-Party Payment Calculation
What’s happening: The Centers for Medicare & Medicaid Services finalized changes to how states calculate the hospital-specific cap for Medicaid disproportionate share hospitals (DSH).
What else to know: The rule is effective April 23.
CHA Will Host Vitality Payer Scorecard Webinar
This post has been archived and contains information that may be out of date.
What’s happening: CHA is hosting a complimentary, members-only webinar on Feb. 27 at 10 a.m. (PT) to highlight the American Hospital Association Vitality Payer Scorecard, which was recently endorsed by the CHA board.
What else to know: The scorecard captures necessary and normalized data points without sharing protected health information. The automated process is based on de-identified claims and remittance files and eliminates the need for CHA surveys on this issue.
CHA Fact Sheets Show New Behavioral Health Facilities Being Built
What’s happening: To help CHA members learn about new behavioral health facilities being constructed in communities around the state, CHA has created an online document that displays the funds awarded to build various types of facilities by county.
What else to know: Close to $2 billion in state funds have been distributed throughout California during the past two years to build new behavioral health treatment locations that will serve Medi-Cal beneficiaries.