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.
In advance of the transition of pharmacy services to Medi-Cal Rx starting on Jan. 1, 2021, the Department of Health Care Services recently launched a training registration application on the Medi-Cal Rx portal for Medi-Cal prescribers and pharmacies.
In a large showing of bipartisan support, 47 of the 53 members of the California congressional delegation sent a letter urging Speaker Pelosi and Minority Leader McCarthy to eliminate the scheduled cuts to Medicaid disproportionate share hospitals (DSH) for two years.
CHA has developed for members a new infographic on the Hospital Fee Program, highlighting the expected changes between the 2017-19 Hospital Fee Program (V) and the 2019-21 Hospital Fee Program (VI). The infographic illustrates the shift in payment structure toward managed care “directed payments,” which requires a hospital to be a network provider to receive a payment.
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.
The Centers for Medicare & Medicaid Services (CMS) has issued a final rule implementing reductions to Medicaid disproportionate share hospital (DSH) allotments, as required by the Affordable Care Act, beginning in federal fiscal year (FFY) 2020 through FFY 2025.
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.
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.