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.

Key Priorities for 2026 Shaping Up

As your association looks to the coming year to advance policies that support the critical services California hospitals provide, three key areas are coming into sharper focus: 

CHA Infographic Explains Looming Medicare Cuts

What’s happening: CHA created an infographic on the looming 4% Medicare sequester cut that could go into effect Feb. 1, 2026, if Congress does not act. The sequester would apply to all traditional Medicare payments including inpatient, outpatient, and physician fee schedule services.  

CMS Clarifies Claims Hold, Will Process Physician Fee Schedule Claims

What’s happening: The Centers for Medicare & Medicaid Services (CMS) clarified that Medicare administrative contractors (MACs) should process certain claims dated Oct. 1 or later, including Medicare physician fee schedule claims, ground ambulance transport claims, federally qualified health center claims, and telehealth claims that CMS can confirm are for behavioral health services.  

CHA Publishes Lobbying Percentage of Dues for Medicare Cost Reports

What’s happening: Hospitals are required to adjust their Medicare cost reports to eliminate the portion of association membership dues related to certain unallowable lobbying expenses, as defined by Medicare. Each year, CHA calculates the unallowable-cost portion of association dues, which differ by geographic region and by tax status.   

2025 Hospital Finance & Reimbursement Conference

What’s happening: On Nov. 3-4, California hospital finance experts will gather at CHA’s members-only Hospital Finance & Reimbursement Conference to examine the fiscal impact of state and federal regulations and policies on hospitals.