Medi-Cal

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.

Reminder: Hospital Fee Program Invoices Due Nov. 27

What’s happening: On Nov. 27, payments for the 2024 Hospital Fee Program, fee-for-service payment cycle 6, are due to the Department of Health Care Services (DHCS).   

What else to know: DHCS mailed invoices to hospitals on Oct. 28.     

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 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.