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 for Californians, including care for more than 50% of all births, 46% of behavioral health-related emergency department visits, 58% of rural hospital patient care days, 1 million inpatient stays, and nearly 16 million outpatient visits in 2018. CHA is committed to protecting Medi-Cal rates and assuring that the state’s neediest maintain access to the high quality of care that all Californians deserve.
CHA encourages members to participate in an upcoming meeting on the Governor’s Executive Order that would transition pharmacy services from Medi-Cal managed care plans into the fee-for-service delivery system by January 2021 — which will impact hospitals that participate in the 340B Drug Discount Program. The meeting will be held July 24 from 9:30-11:30 a.m. in Sacramento, and is designed to facilitate community awareness and provide a forum for stakeholder feedback.
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.
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.
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 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).
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.