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Medicare Coverage for Behavioral Health Expanded

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What’s happening: The Department of Health Care Services (DHCS) announced that Medicare will cover visits with mental health counselors, addiction counselors, and marriage and family therapists, effective since Jan. 1. 

What else to know: The Centers for Medicare & Medicaid Services (CMS) will conduct both routine and focused program audits of Medicare Advantage (MA) organizations in 2024 to assess compliance with new requirements. 

CMS Provides “Two-Midnight Rule” Guidance for Medicare Advantage Plans

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What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued a frequently asked questions (FAQ) document on finalized contract year 2024 Medicare Advantage (MA) policies.   

What else to know: The document provides guidance on how the “two-midnight” hospital admissions policies apply to MA patients when MA organizations are permitted to deny payment through post-claim audits. 

Changes Finalized to Substance Use Disorder Record Sharing Rules

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What’s happening: The U.S. Department of Health and Human Services (HHS) issued long-awaited regulations implementing changes to requirements for sharing substance use disorder (SUD) patient data.  

What else to know: The CHA-supported regulations are intended to better align SUD record-sharing rules with Health Insurance Portability and Accountability Act (HIPAA) requirements.  

CHA DataSuite Released Medicare Hospital FFY 2025 Wage Index and Occupational Mix Revised Data Analysis

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What’s happening: CHA DataSuite has issued a hospital-specific analysis of the Medicare hospital federal fiscal year (FFY) 2025 wage index and occupational mix data. 

What else to know: The data has been revised and is the second of three wage and occupational mix data public use files (PUFs) that the Centers for Medicare & Medicaid Services (CMS) issued to develop the hospital wage index for FFY 2025. 

CHA Will Host 2024 Hospital Finance and Reimbursement Seminar

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What’s happening: CHA will host a one-day seminar on March 11 (Sacramento) and 13 (Burbank) at 8 a.m. to discuss how Medicare, Medi-Cal, and other hospital reimbursements will be impacted by the state and federal regulatory environment, recently enacted and anticipated policies, and the new Office of Health Care Affordability (OHCA). 

What else to know: The program will discuss key policies, challenges, and opportunities. Registration is open.  

CHA Will Host Inpatient Rehabilitation Facility Webinar

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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.  

Updates for the Week of Feb. 5

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This post has been archived and contains information that may be out of date.CMS Selects Inpatient Hospitals as Targeted for FY 2026 Validation  January 2024 Care Compare and Provider Data Catalog Data Refresh for Hospitals  CMS Releases April 2024 Public Reporting Hospital Data for Preview  Medicare Physician Fee Schedule: New CPT Codes for RSV Vaccine […]

Hospital Data Sharing Portal Now Open

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What’s happening: On Jan. 31, California health care organizations were required to begin sharing electronic health records under the California Data Exchange Framework (DxF).    

What else to know: The Center for Data Insights and Innovation (CDII) launched the participant directory in the Data Sharing Agreement (DSA) Signing Portal last week. All participants are required to enter their information via the DSA Signing Portal.