Medi-Cal

About Medi-Cal

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.

Medicaid DSH Cuts Delayed Until Nov. 21 Through Federal Budget Continuing Resolution

Yesterday, the U.S. Senate passed a continuing resolution to provide funding for the federal government for the first few weeks of federal fiscal year 2020, which begins Oct. 1. Of particular note for California’s safety-net hospitals, the measure includes a provision to delay the Medicaid disproportionate share hospital (DSH) cuts slated to take effect on Oct. 1. The delay is in place until Nov. 21. 

CHA Submits Joint Letter on Proposed Rule to Rescind Methods Assuring Access to Covered Medi-Cal Services

CHA, the California Association of Public Hospitals and Health Systems, Private Essential Access Community Hospitals, Inc., the California Children’s Hospital Association, and the District Hospital Leadership Forum have submitted a joint letter opposing the Centers for Medicare & Medicaid Services’ (CMS) proposed rule that would rescind current requirements for the way states assure access to covered Medicaid services.

Advisory Group Meeting on Medi-Cal Pharmacy Carve-Out Set for July 24

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.

DMHC Releases Guidance on General Licensure Regulation

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. 

DHCS Releases Access Assessment Draft, Comments Due June 28

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.  

Supreme Court Rejects Medicare Disproportionate Share Hospital Cuts

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.

DHCS Invites Hospitals to Participate in Medical Interpretation Services Survey

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.