What’s happening: Last week, CHA submitted a letter to the California Department of Public Health’s (CDPH) Center for Health Care Quality to recommend several changes to the draft regulations on acute psychiatric hospital staffing, which are proposed to take effect on Jan. 31.
(more…)Immediate Compliance with New Acute Psychiatric Hospital Staff Ratios Would Close Patient Beds, CHA Argues
Federal Court Halts Implementation of 340B Rebate Pilot Program
What’s happening: On Dec. 29, 2025, the U.S. District Court of Maine blocked implementation of the federal Department of Health and Human Services (HHS) 340B Rebate Model Pilot Program from going into effect nationwide on January 1, 2026, pending further orders from the court.
(more…)DHCS Granted 60-Day Extension to Revise Hospital Fee Program 9 Application
What’s happening: The Department of Health Care Services (DHCS) has until March 13 to submit a revised 2025 Hospital Quality Assurance Fee Program application to the Centers for Medicare & Medicaid Services (CMS), following questions CMS raised about the program’s size.
(more…)Positive News and Looming Threats from the Nation’s Capital
Federal lawmakers are back in Washington, D.C., this week with just over three weeks left to finish funding the government before current spending laws run out on Jan. 30.
(more…)Issue Brief: Time Is Running Short to Save Hospitals, Preserve Access to Health Care
California’s hospitals — and the patients they care for — have never been in greater jeopardy than they are today.
The Issue
A perfect storm of state and federal policy changes, a rapidly aging population with greater needs, and record inflation are forcing hospitals to shutter services, lay off employees, or — in some cases — close altogether.
In the past three years, four California hospitals have closed or been saved from closure by last-minute bailouts. In 2025 alone, five hospitals shuttered service lines, including vital maternity units, pediatric units, and more. And last year, more than 3,500 hospital workers in California lost their jobs — solid, middle-class positions that the state needs for a strong economy.
The worst part is that things are about to get even more dire:
- In the coming months and years, nearly 2 million Californians are expected to lose their health care coverage. But they won’t stop getting sick and needing hospital care — that means a significant increase in the free charity that hospitals will need to provide.
- Additional federal cuts to Medicaid (Medi-Cal) — the largest in the nation’s history — will strip tens of billions from California’s health care system. These cuts will hit different hospitals in different ways, with the greatest losses borne by those in communities with high reliance on Medi-Cal coverage. And new state restrictions on how much can be spent to care for Californians are leading insurance companies to reduce their payments to hospitals, shrinking resources for care even more.
- At the same time, through the Office of Health Care Affordability, the state is rationing the amount of resources hospitals can spend to care for Californians, with no regard for the impact that will have on access to care, health equity, quality of care, and more.
What’s Needed
Policymakers must act quickly before more jobs are shed, more services are lost, more hospitals close, and more patients are left in the lurch.
- At the federal level, the Centers for Medicare & Medicaid Services must approve California’s pending Medicaid financing proposal, a lifeline for struggling hospitals. Also, Congress should permanently protect funding for disproportionate share hospitals (many of which are at significant risk of closure), preserve the 340B Drug Pricing Program, reject site-neutral hospital cuts, and preserve health insurance coverage.
- At the state level, on the heels of the largest federal cut to health care in the nation’s history, California must provide financial support for rural and other struggling hospitals, analyze the actual cost to the health care system of significant pending legislation, reduce the regulatory costs to deliver health care, and examine reforms to the Office of Health Care Affordability to protect access to health care.
Key Messages: California’s Health Care System Is on Life Support
The risk of losing access to critical health care services for Californians has never been greater.
- In the past three years alone, two hospitals in California have been forced to close. Another 22 have had to shutter maternity units just to stay afloat, leaving 12 counties without maternity care. Today, dozens more are facing similar grim choices, with more than 40 hospitals at significant short-term risk of closure.
- Statewide, 44% of hospitals lose money every day caring for patients, and operating expenses for California hospitals collectively exceed patient care revenues by $2.8 billion a year.
- This is at a time when the cost of providing health care continues to rise exponentially. Labor costs — the largest share of hospital spending on care — have increased 51% since 2019, more than twice the rate of general inflation.
At a time when hospitals are already challenged like never before, recent federal and state policy changes will make it even more difficult for Californians to get the care they need.
- In the coming months and years, nearly 2 million Californians are expected to lose their health care coverage. But they won’t stop getting sick and needing hospital care — that means a significant increase in the free care that hospitals will need to provide.
- Additional federal cuts to Medicaid (Medi-Cal) will strip tens of billions of dollars from California’s health care system over the next decade. These cuts will hit different hospitals disproportionately, with those in communities with high reliance on Medi-Cal coverage seeing the greatest losses.
- New restrictions from the Office of Health Care Affordability on how much can be spent to care for Californians are leading insurance companies to reduce their payments to hospitals, shrinking resources for care even more.
Time is running short for action that would protect patients and communities from longer wait times, living in health care deserts, and worsening health outcomes.
- At the state level, on the heels of the largest federal cut to health care in the nation’s history, California must provide financial support for rural and other struggling hospitals, analyze the actual cost to the health care system of significant pending legislation, reduce the regulatory costs to deliver health care, and examine reforms to the Office of Health Care Affordability to protect access to health care.
- At the federal level, Congress must permanently protect funding for disproportionate share hospitals (those at great risk of closure), preserve the 340B Drug Pricing Program, and reject site-neutral cuts to hospitals. It’s also critical that the Centers for Medicare & Medicaid Services approve the next version of the Hospital Fee Program, a lifeline without which dozens more hospitals could close.
- Over the long term, state and federal policymakers should create opportunities to transform California’s health care system to be more effective and more efficient, in part by addressing upstream drivers of health.
Infographic: Financial Instability
Specialized Stomach Procedure and Care Team Aid Teen’s Weight Loss Journey
Jasmine struggled with severe pediatric obesity for years. Luckily, the Bariatric Surgery Program at Children’s Hospital Los Angeles saved the day. Their team performed a specialized stomach procedure and developed a care team of doctors, surgeons, dietitians, and psychologists that aided Jasmine in losing more than 170 pounds. A year and a half post-surgery, Jasmine is focused on the future: “Now, I can walk for miles without pain or getting tired.”
(more…)Summaries Available for CY 2026 Home Health, End-Stage Renal Disease Payment Final Rules
What’s happening: Summaries of the calendar year (CY) 2026 home health prospective payment system (PPS) and end-stage renal disease (ESRD) PPS final rules are available for CHA members.
(more…)CA Medical Board Reminds Providers of Three-Day Rule for Narcotic Prescriptions
What’s happening: The Medical Board of California has distributed its annual notice reminding prescribers that, under federal law, certain authorized practitioners may dispense a three-day supply of Schedule II medications in emergency situations in order to initiate maintenance or detoxification treatment.
(more…)