Medicare

About Medicare

The federal Medicare program is an essential pillar of the state’s health care system, supporting more than 6 million Californians over the age of 65 and younger Californians with disabilities. One in five hospitals is at risk of closing, in part because Medicare reimbursement rates are far lower than the cost of providing care. It’s essential that future federal Medicare policy protects patient care.

CHA Supports Federal Bill to Preserve Access to Care in Rural Communities

What’s happening: CHA sent a letter to the California congressional delegation in support of the Preserving Emergency Access in Key Sites (PEAKS) Act (H.R. 7931). 

What else to know: The legislation would protect critical access hospitals (CAHs) in rural and mountainous areas by correcting a misalignment in Medicare’s CAH ambulance reimbursement requirements. 

CHA Comments on IPPS Proposed Rule

What’s happening: CHA asked the Centers for Medicare & Medicaid Services (CMS) to increase the payment update in comments on the federal fiscal year 2025 inpatient prospective payment system (IPPS) proposed rule. 

What else to know: Members are encouraged to use CHA’s letter as a template to submit comments, which are due on June 10. 

CHA Comments on Data Collection for MA Plans

What’s happening: CHA submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to a request for information related to data collection for Medicare Advantage (MA) plans. 

What else to know: CHA strongly encourages CMS to use the formal rulemaking process to implement additional data collection and reporting requirements. 

CHA to Host Medicaid Managed Care Final Rule Webinar

What’s happening: CHA will host a members-only webinar on June 4 at 10 a.m. (PT) to discuss the Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality rule, which was finalized by the Centers for Medicare & Medicaid Services (CMS). 

What else to know: The rule finalizes significant changes and clarifications regarding managed care delivery and finance.    

CHA Comments in Response to IRF, IPF Payment Proposed Rules

What’s happening: CHA submitted comments in response to the federal fiscal year 2025 inpatient rehabilitation facilities (IRF) and inpatient psychiatric facilities (IPF) prospective payment system proposed rules. 

What else to know: Comments were due to the Centers for Medicare & Medicaid Services by 2 p.m. (PT) on May 28.  

House Approves Bills Focused on Rural Health Care

What’s happening: The House Ways and Means Committee approved six bills that address a wide range of pressing health care issues facing rural communities. 

What else to know: CHA will continue to work with members of the California delegation to support these measures and urge their passage into law. 

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.   

CHA DataSuite Releases FFY 2025 Medicare Long-Term Care Hospital Prospective Payment System Proposed Rule Analysis

What’s happening: CHA DataSuite issued a hospital-specific analysis of the federal fiscal year (FFY) 2025 Medicare long-term care hospital (LTCH) prospective payment system proposed rule.  

What else to know: The analysis is intended to show hospitals how Medicare LTCH fee-for-service payments would change from FFY 2024 to FFY 2025 based on the policies set forth in the proposed rule.