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.
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.
Invite Members of Congress to Your Hospital; Critical Health Care Votes Coming in December
Yes on Proposition 35 Campaign Materials Available to CHA Members
What’s happening: The Yes on Proposition (Prop) 35 campaign is heating up — members are encouraged to join the coalition supporting the initiative, 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.
What else to know: Campaign materials — including buttons, stickers, pocket cards, pamphlets, and window signs in both English and Spanish — are now available to order.
Update: Key CHA Bills Move Forward as Legislative Session Nears End
What’s happening: Two CHA-sponsored bills are on the governor’s desk and others are working their way through the legislative process. The Legislature is set to adjourn Saturday night.
What else to know: Awaiting action from the governor: Assembly Bill (AB) 1423 would create a critical access hospital funding technical advisory group and AB 1316 would require Medi-Cal managed care plans to pay hospital emergency departments for serving Medi-Cal beneficiaries experiencing a mental health crisis.
DHCS Releases CalAIM Transitional Care Resource
What’s happening: The Department of Health Care Services (DHCS) has issued a new resource to support the development and implementation of transitional care services, a component of California Advancing and Innovating Medi-Cal (CalAIM), the state’s Medi-Cal reform initiative.
What else to know: Under CalAIM, Medi-Cal managed care plans are responsible for delivering transitional care services to members who are transferred from one setting or location to another, such as discharged from a hospital to a skilled-nursing facility or to home. As envisioned, these services support individuals from the start of the discharge planning process through their transition until they have been successfully connected to needed long-term services and support.
State Medicaid Agencies Can Apply for CMS Grant by Sept. 20
What’s happening: The California Department of Health Care Services (DHCS) is preparing to apply for a federal grant related to the Transforming Maternal Health (TMaH) model, which is projected to run for 10 years.
What else to know: The Centers for Medicare & Medicaid Services (CMS) is accepting applications through Sept. 20. DHCS is planning to apply, with its pilot plan operating in Madera, Fresno, Kings, Tulare, and Kern counties.
Hospitals Are Invited to Complete CalAIM Survey
What’s happening: The California Health Care Foundation (CHCF) and the Lucile Packard Foundation for Children’s Health are asking providers to share their experiences in a survey about the implementation of Medi-Cal’s California Advancing and Innovating Medi-Cal (CalAIM) waiver.
What else to know: This survey is a follow-up to the initial survey conducted in the summer of 2023. The findings will be made public to help stakeholders, including policy makers, understand how CalAIM implementation is progressing. CHCF is asking hospitals to identify both the positives and the areas for improvement.
Hospitals Can Now Apply for Funds to Treat Patients with Behavioral Health Needs
What’s happening: Following the March 2024 passage of CHA-supported Proposition 1, applications are now open for $4.4 billion in new Behavioral Health Continuum Infrastructure Program (BHCIP) funding to support capital projects that expand the behavioral health services continuum.
What else to know: Hospitals can start the application process now for the first round of grants. Required pre-application consultation must be requested by Oct. 15, and applications are due by Dec. 13.
With a Month Left in Session, Positive News on Many Bills
Next month, state legislators will return from their summer recess and finalize the outcome of hundreds of bills — including dozens that will have some bearing on hospital care — before concluding the 2024 session on Aug. 31.