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.
CMS Guidance Clarifies Hospital Respiratory Illness Data Reporting Requirements Effective Nov. 1
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued guidance to hospitals and state surveyors that underscores the importance of following reporting requirements for new hospital respiratory illness data reporting conditions of participation (CoP).
What else to know: CMS also clarifies in the guidance that psychiatric hospitals and rehabilitation hospitals will report their daily COVID-19, influenza, and respiratory syncytial virus data annually rather than weekly.
California’s Hospitals, Doctors Seek Congressional Delegation Support in Preserving Access to Care
What’s happening: In a joint letter to the California congressional delegation, CHA and the California Medical Association (CMA) asked members to support access to health care for all Californians in year-end legislation.
What else to know: Critical federal health care legislation on Medicaid, Medicare, and telehealth will be up for votes in December.
California Reaches $55 Million Settlement Agreement with L.A. Care Health Plan
What’s happening: On Oct. 8, California Department of Managed Health Care (DMHC) and Department of Health Care Services (DHCS) officials announced they have reached settlement agreements with the largest Medi-Cal plan in the state.
What else to know: The two agreements with the Local Initiative Health Authority for Los Angeles County (L.A. Care Health Plan) — a $35 million settlement with the DMHC and a $20 million settlement with the DHCS — require that L.A. Care Health Plan improve its operations to ensure timely access to medically necessary health care services for all plan members, among other actions.
Prop 35 Campaign Releases Hospital-Specific Social Media Toolkit
What’s happening: The election is 24 days away, and every vote is critical — help spread the word to vote yes on Proposition (Prop) 35 with the new Prop 35 Social Media Toolkit for Hospitals.
What else to know: Hospitals that aren’t yet members of the coalition supporting Prop 35 — which would make permanent an existing fee on managed care organizations that enables the state to draw on federal matching funds to improve Medi-Cal — can still join.
Hospital Fee Program Invoices Due Oct. 23
What’s happening: Payments for the 2024 Hospital Fee Program, fee-for-service payment cycle 6, are due to the Department of Health Care Services (DHCS) on Oct. 23.
What else to know: Invoices were mailed to hospitals from DHCS on Sept. 23.
Ask Reps. to Sign Letter Opposing 340B Program Changes
What’s happening: A bipartisan group of U.S. representatives is leading a letter to U.S. Health and Human Services (HHS) Secretary Xavier Becerra about efforts by Johnson & Johnson (J&J) to undermine the 340B Drug Discount Program.
What else to know: Hospital leaders should call or email their U.S. representative and urge them to sign on to the letter by Sept. 27.
Hospital Fee Program Invoices Due Sept. 25
What’s happening: Payments for the 2022 Hospital Fee Program fee-for-service payment cycle 5 are due to the Department of Health Care Services (DHCS) on Sept. 25.
What else to know: Invoices were mailed to hospitals from DHCS on Sept. 5.
DHCS Takes Steps to Expedite Access to Enhanced Care Management
What’s happening: Effective Jan. 1, 2025, Medi-Cal managed care plans (MCPs) must implement presumptive authorization arrangement with select providers of enhanced care management (ECM).
What else to know: The Department of Health Care Services (DHCS) is releasing updates to the ECM presumptive authorization policy parallel to the ECM Referral Standards that, together, are designed to ease the administrative burden of the referral and authorization process on ECM providers and community referral partners.
CHA to Host Webinar on New Reimbursement Options for Inpatient Psychiatric Care
What’s happening: CHA is hosting a members-only webinar on Sept. 30 at 1 p.m. (PT) on new Medi-Cal reimbursement options for inpatient psychiatric care.
What else to know: During this webinar, expert speakers will describe new options for hospitals seeking reimbursement for the inpatient psychiatric care they provide to Medi-Cal beneficiaries. Registration is open.