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.
About Medi-Cal
DHCS Releases Diagnosis-Related Group 2021-22 Grouper Setting Updates
On April 6, the Department of Health Care Services updated its state fiscal year (SFY) 2021-22 Diagnosis-Related Group grouper settings documents to reflect 3M Grouper Software mapper and hospital-acquired conditions updates that took effect on April 1.
The Middle Innings of the Legislative Cycle
If California’s legislative session — which runs from January through the end of September — can be looked at as a nine-inning baseball game, we’re just weeks away from the middle three innings. That means legislative priorities are coming into sharper focus and strategy is beginning to turn to tactics.
Same State, Different Worlds
There are two Californias when it comes to health care. In one, patients and communities are well-served by their health care system. Physicians, nurses, pharmacists, and other providers are easily accessible, offer a wide variety of services at multiple locations, and deliver care using the latest technology. In the other, care sites are harder to […]
DHCS to Host Webinar on Medi-Cal Managed Care Plan Request for Proposal
The Department of Health Care Services (DHCS) will host a webinar on Feb. 15 from 3:30 to 5 p.m. (PT) to share how the agency will leverage the managed care plan request for proposal (RFP) and managed care contracts to further DHCS’ goal of enhancing how care is delivered to Medi-Cal members.
Medi-Cal Investments Needed to Expand Coverage, Improve Health Equity
Two years into the worst pandemic in a century — a crisis that has claimed the lives of more than 80,000 Californians — every Californian knows firsthand the importance of having quick, reliable access to quality health care.
DHCS Reminds Health Plans of Responsibilities Post-Medi-Cal Rx
As previously shared, the Department of Health Care Services (DHCS) transitioned all Medi-Cal managed care outpatient pharmacy services billed on pharmacy claims to the fee-for-service (FFS) delivery system on Jan. 1 — the much-anticipated implementation of Medi-Cal Rx.
Budget Proposal Offers Solid Start to Rebuild Health Care System
For all of you who are on the front lines working extraordinary hours to respond to the unbelievable spread of omicron over the past several weeks, it might have been easy to overlook the Monday release of Gov. Gavin Newsom’s 2022-23 budget proposal, which includes a slew of important health care initiatives.
DHCS Releases CalAIM Major Organ Transplant Guidance
Based on requests from stakeholders, including CHA, the Department of Health Care Services has released guidance on the reimbursement requirements associated with the California Advancing and Innovating Medi-Cal (CalAIM) major organ transplant changes.
CMS to Enforce Vaccine Mandate Rule, Interpretive Guidelines for Surveyors Issued
Provider Resources on Enhanced Care Management, Community Supports Available
On behalf of the Department of Health Care Services (DHCS), Aurrera Health Group has released an Enhanced Care Management (ECM) Provider Toolkit and Community Supports Explainer. In addition, DHCS is hosting a webinar at 9 a.m. (PT) on Jan. 7 that will include an update on ECM and Community Supports implementation and review the new provider resources, including the ECM Provider Toolkit and Community Supports Explainer, and the ECM Outreach and Member […]