CHA Issues Summaries of CY 2025 OPPS, Physician Fee Schedule Final Rules

What’s happening: Summaries of the calendar year (CY) 2025 outpatient prospective payment system (OPPS) and physician fee schedule final rules are available for CHA members. 

What else to know: The rules are effective Jan. 1, 2025.  

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182 Members of Congress Sign Letter to Prevent Medicaid DSH Cuts

What’s happening: A bipartisan letter asking House leadership to prevent upcoming Medicaid disproportionate share hospital (DSH) payment cuts gathered 182 signatures — including 36 from the California delegation. CHA thanks hospital leaders for their outreach on this critical issue.  

What else to know: Reductions in Medicaid DSH payments to states are scheduled to take effect on Jan. 1, 2025. If these cuts go into effect, California’s hospitals would lose $1.2 billion in 2025.  

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CHA DataSuite CY 2025 HH Final Rule Impact Analysis Shows How Medicare FFS Payments Will Change

What’s happening: CHA DataSuite has issued a hospital-specific analysis of the calendar year (CY) 2025 Medicare home health (HH) prospective payment system final rule analysis.  

What else to know: The analysis is intended to show HH providers how Medicare fee-for-service (FFS) payments will change from CY 2024 to CY 2025 based on the policies set forth in the final rule. A detailed summary of the final rule is available for CHA members. 

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CHA Symposium Focuses on New Approaches to Behavioral Health Care

What’s happening: More than 250 health care professionals and hospital leaders from across California gathered in Long Beach on Dec. 4-5 for CHA’s annual Behavioral Health Symposium.  

What else to know: Attendees discussed innovative ways to connect patients to community-based care and tackle stigma, updates to California’s involuntary treatment and emergency services laws, and more. 

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Thank You To Our CHPAC 2024 Donors

Corporate Donors

Support for CHPAC is entirely voluntary. CHPAC raises funds from individuals who, acting in their personal capacities and on their own time, wish to support CHPAC’s activities. CHPAC collects information from supporters regarding their employment solely for purposes of compliance with campaign finance disclosure rules (although it reserves the right to use that information to track sources of support, as well). CHPAC conducts its activities independently of any hospital, and the reference to any organization in connection with any CHPAC supporter is for identification purposes only, and does not indicate endorsement by such organization of CHPAC or its activities.

Upcoming EMSA Commission Meeting to Discuss APOT Report

What’s happening: On Dec. 11, the Commission on Emergency Medical Services will convene in San Francisco, where it will discuss an ambulance patient offload time (APOT) report, among other topics. 

What else to know: The report in the Emergency Medical Services Authority (EMSA) Commission Meeting Packet includes APOT data by hospital. More details for the in-person meeting can be found on the EMSA web page. See CHA’s APOT issue web page for additional resources.  

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DMHC Fines Blue Cross of California for Failing Cancer Patient, Ignoring Complaints

What’s happening: The California Department of Managed Health Care (DMHC) has fined Blue Cross of California (Anthem Blue Cross) $500,000 after a health plan member was forced to file 17 grievances in order to obtain coverage for cancer care, including chemotherapy.  

What else to know: Anthem Blue Cross has acknowledged its failure to respond to the member’s grievances and agreed to pay the fines, repay providers, and take corrective action involving the grievance process.   

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As 2024 Winds Down, Federal Advocacy Heats Up

As 2024 begins to come to a close, CHA’s advocacy attention will be focused on advancing priorities in Washington, D.C. We’ll be pushing to ensure federal approval for two critical state issues while also focusing on some key federal issues likely in play in the lame duck session. 

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Proposed Rule Would Increase Medicare Advantage Plan Oversight

What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for contract year 2026 that would increase oversight of Medicare Advantage (MA) plans.  

What else to know: The rule includes additional proposed changes to the prior authorization process and guardrails for artificial intelligence use.  

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Urge Congress to Support Patient Care in Year-End Legislation

What’s happening: CHA issued an alert asking members to urge their congressional representatives to support hospital priority issues in year-end legislation. 

What else to know: Outreach is needed by Dec. 20 when Congress will wrap up the session.  

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