CEO Message

CEO Message: Good News on Proposed Federal Medi-Cal Cuts

On Monday, the Centers for Medicare & Medicaid Services (CMS) announced its intent to withdraw a proposal that would have cut total Medicaid funding by as much as $49 billion annually (8% of the program).  

The decision was made after significant opposition from providers — CHA worked closely with other hospital groups in California, other state hospital associations and the American Hospital Association to coordinate our opposition — alongside state regulators, governors, members of Congress, and patient advocacy groups. 

It comes at a critical time when hospitals continue to work through heavy financial losses driven by COVID-19. It also comes at a time when California’s hospitals are responding not only to the pandemic, but record-setting wildfires as well. 

Withdrawal of the Medicaid Fiscal Accountability Rule is a reprieve that hospitals need right now. 

While CMS has signaled the regulation will be removed from its 2020 fall regulatory agenda, the proposal must still be formally withdrawn. If it had been carried forward, it would have had a devastating impact on California — home to 13 million Medi-Cal enrollees, the most in the nation. 

At a time when COVID-19 could deplete California’s hospitals of more than $20 billion in resources for patient care, this rule would have been devastating. 

As with any rule, there is a chance this one could return, even if in a different form. The federal government has long been concerned with the integrity of the Medicaid program, and when the Trump administration proposed the rule in November, it noted concern that states were gaming the state-federal Medicaid financing system to collect additional federal dollars. That means the issue will likely remain a policy priority no matter who wins the election in November. 

We’ll keep vigilant and inform you of any developments but, for now, vital funds for Medi-Cal patients will remain secure. 

~ Carmela

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Human Resources

CHA News Article

Governor Signs COVID-19-Specific Workers’ Compensation Presumption Law 
For human resources executives

Today, Gov. Newsom signed Senate Bill 1159, adopting a COVID-19-specific presumption in the workers’ compensation system for employees who test positive for COVID-19. The new law takes effect immediately.

CHA News Article

Major Revisions to Federal Leave Law Impact Public Hospitals, Small Private Employers
For chief compliance officers, in-house general counsel & legal staff, human resources professionals, risk managers 

Effective Sept. 16, the health care exemption in the federal Families Coronavirus Response Act (FFCRA) was significantly narrowed. The act, originally passed in March, contains two paid leave provisions and applies to all public employers and private employers with fewer than 500 employees. It includes an opt-out provision for employers of “health care providers.”

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CHA News Article

CMS Proposes Changes to CY 2022 Medicare Advantage Risk Adjustment Policies
For CFOs, finance & reimbursement staff, government relations staff

The Centers for Medicare & Medicaid Services (CMS) has issued Part I of the calendar year 2022 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies. This proposes changes to the Part C CMS-Hierarchical Condition Categories (HCC) risk adjustment model as required by the 21st Century Cures Act, which mandates a 60-day comment period. 

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Federal Advocacy

CHA News Article

President Trump Signs Executive Order to Lower Prescription Drug Prices
For CFOs, finance & reimbursement staff, government relations staff

Earlier this week, President Trump issued a new executive order on lowering drug prices. It directs the U.S. Health and Human Services Secretary to immediately take steps to conduct rulemaking on a model that would test limiting Medicare payments for Part B drugs to no more than a “most-favored-nation” price.

CHA News Article

CDPH Describes Hospital Surge Monitoring Visits, Other Survey Activity
For licensing & certification staff, quality and patient safety staff

The California Department of Public Health (CDPH) has issued All Facilities Letter (AFL) 20-69, which outlines the survey activities the department will conduct for both hospitals and skilled-nursing facilities. Based on the daily COVID-19 data reported by hospitals, if CDPH determines a hospital is at risk of surging, the hospital will receive a phone call about its surge plan, any urgent needs, and whether it needs assistance from CDPH.

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Post-Acute Care

CHA News Article

CMS Publishes Clarifications on Inpatient Rehabilitation Facility, Long-Term Care Hospital Data Sets
For inpatient rehabilitation facility leaders, long-term care hospital leaders, quality and compliance officers

The Centers for Medicare & Medicaid Services (CMS) has published quarterly guidance and clarifications for the inpatient rehabilitation facility patient assessment instrument (IRF-PAI) and the long-term care hospital continuity assessment record and evaluation (LTCH CARE) data sets.  

CHA News Article

CMS Seeks Input on Skilled-Nursing Facility Quality Measure Development
For skilled-nursing facility leaders, compliance staff, quality management staff

The Centers for Medicare & Medicaid Services (CMS) has posted for public review draft specifications for the Skilled-Nursing Facility (SNF) Healthcare-Associated Infections Requiring Hospitalizations measure for the SNF Quality Reporting Program. 

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CMS News Roundup

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