What’s happening: This week, OHCA released a close-to-final draft regulation and supplemental guidance on the total health care expenditure data collection process, which contains few substantive changes from the prior draft version.
What else to know: Payers remain responsible for reporting the data under the revised guidance. CHA remains concerned about the lack of transparency and standardization and urges members to contact OHCA on its related spending target proposal using the template letter and talking points included in this week’s alert.
The Office of Health Care Affordability (OHCA) is tasked with slowing the growth of health care spending, principally by setting and enforcing a target for the annual growth in per capita total health care expenditures (THCE). Last year, OHCA proposed draft regulations related to the collection of these data.
On Feb. 12, OHCA staff released revised draft regulations and supplemental guidance on the data collection process. In addition, OHCA has published an updated attribution addendum, which identifies provider organizations that OHCA anticipates will have reportable medical expenditures and therefore be subject to potential enforcement against the spending target. (Payers likely will identify additional provider organizations with reportable expenditures.)
These proposed regulations are likely very close to their final version. No sooner than Feb. 19, OHCA will formally file these proposed regulations with the Office of Administrative Law (OAL). From this filing date, the public will have five days to submit comments on the proposed regulations. Five days later, OAL may finalize the regulations, which will then become effective for five years (pursuant to the emergency rulemaking authority in OHCA’s authorizing legislation).
The revised regulations and guidance are largely substantively unchanged from the previous version. They continue to place the reporting requirements on payers rather than providers.
Unfortunately, the updated regulations do not provide greater transparency and standardization around the data reported by payers. These were two priority improvements requested by CHA when the draft regulations were up for public comment. CHA will continue to press for these and other improvements, as well as reconsideration of OHCA staff’s proposed 3% spending growth target.
This week, CHA issued a member alert asking for two things:
- Participation in the public comment portion of the Feb. 28 OHCA board meeting
- Submission of a comment letter on the proposed 3% spending growth target by March 11
For more information, contact Ben Johnson, vice president, policy, at bjohnson@calhospital.org.
