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.
CMS Provides Additional Guidance on Beneficiary Observation Status Appeals
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has issued additional information, including billing instructions, for the Medicare Change of Status Notifications (MCSN).
What else to know: Beginning Feb. 14, CMS will require giving MCSNs to patients who are reclassified from inpatient to observation (outpatient) status.
CHA Webinar Covers New Medicare Conditions of Participation Updates
What’s happening: CHA will host a members-only webinar on Jan. 29 from 11 a.m. to noon (PT) to discuss the new Medicare Conditions of Participation (CoP) updates for obstetrical and other services. Registration is open.
What else to know: The requirements will be phased in over two years, with the first of the requirements in effect July 1.
CMS Proposes Payment Updates for Medicare Advantage, Part D Plans for CY 2026
What’s happening: On Jan. 10, the Centers for Medicare & Medicaid Services (CMS) issued advance notice of proposed capitation rate and payment updates for Medicare Advantage (MA) and Part D plans for calendar year (CY) 2026.
What else to know: The final 2026 rate announcement is expected by April 7.
CHA Encourages Members to Participate in the Vitality Index Payer Scorecard
What’s happening: CHA is endorsing member participation in the Vitality Index Payer Scorecard, which will provide critical information to support CHA’s advocacy to hold insurers accountable for timely and accurate reimbursement.
What else to know: The CHA Board of Trustees has endorsed this tool, which will automatically draw de-identified claims and remittance information from hospitals without requiring additional reporting or surveys.