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.
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.
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.
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.
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.
CHA Continues Work to Hold Insurers Accountable
What’s happening: CHA continues to await a response to the lawsuit filed against Anthem Blue Cross on April 23.
What else to know: In the interim, CHA continues to collect information to support its position that many managed care plans, including Anthem Blue Cross, are violating certain provisions of the Knox-Keene Act.
Doula Access in Hospitals: What the Law Requires
Join this webinar and learn more about creating a partnership between your hospital and the doulas that serve your geographic area. Learn about the legal requirements associated with doulas as well as best practices from a hospital with a successful doula program.