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 Will Host Inpatient Rehabilitation Facility Webinar
This post has been archived and contains information that may be out of date.
What’s happening: CHA will host a complimentary, members-only webinar on Feb. 13 at 9 a.m. (PT) to discuss an inpatient rehabilitation facility (IRF) review choice demonstration. Registration is open.
What else to know: The Centers for Medicare & Medicaid Services (CMS) recently introduced the review choice demonstration (RCD) for IRFs in Alabama, with plans to expand the program to California in the near future.
CMS Issues Advance Notice of Proposed Medicare Advantage Payment Changes
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued advance notice of proposed changes to Medicare Advantage (MA) Part C and Part D payments for calendar year 2025.
What else to know: Comments are due to CMS by 2 p.m. (PT) on March 1.
Summary: Finalized Interoperability and Prior Authorization Policies
What’s happening: A members-only summary of finalized interoperability and prior authorization processes is available.
What else to know: The final rule is scheduled for publication in the Feb. 8 issue of the Federal Register.
New Federal Electronic Prior Authorization Requirements Finalized
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has finalized policies to advance interoperability and streamline prior authorization processes by using application programming interfaces (API) technology.
What else to know: The final rule also requires payers to provide a specific reason for denied prior authorization decisions and publicly report certain prior authorization metrics.
CHA Comments on Proposed Changes to Medicare Advantage Plans
What’s happening: CHA submitted comments on the proposed technical changes to Medicare Advantage plans for contract year 2025.
What else to know: Comments were due to the Centers for Medicare & Medicaid Services on Jan. 5.
New Patient Medicare Appeals Processes Proposed
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would establish an appeals process for Medicare beneficiaries who were admitted as an inpatient but whose status changed to outpatient during their hospital stay.
What else to know: Policies are being established in response to a court order following a class action case filed in 2011.
Deadline Approaching to Submit Medicare Physician Attestation Statements
What’s happening: As a condition of participation, Medicare-certified hospitals must complete attestation and acknowledgment of physicians with newly granted admitting privileges in the previous calendar year.
What else to know: Attestation statements for 2022 should be submitted by Dec. 29.
Five California Teaching Hospitals Awarded Additional Residency Slots
What’s Happening: New graduate medical education (GME) residency slots have been allotted to teaching hospitals serving geographic areas and underserved populations.
What Else to Know: Applications for the third round of residency positions will open in January and close March 31.
Summary: Proposed Policy Changes for Medicare Advantage Plans
What’s Happening: A members-only summary from Health Policy Alternatives, Inc. of the proposed policy changes for Medicare Advantage (MA) plans is available.
What Else to Know: The proposed policies affect MA (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plans, and Programs of All-Inclusive Care for the Elderly.
Tell Congress to Vote No on Site-Neutral Payment Cuts
What’s Happening: The U.S. House of Representatives is set to vote on the Lower Costs, More Transparency Act (H.R. 5378), which includes harmful Medicare site-neutral payment cuts as soon as Dec. 11.
What Else to Know: CHA asks members to call or email your U.S. representative and urge them to vote no.