CHA News Article

DHCS Provides Details on Transition to APR-DRG Payment System

Effective July 1, 2013, reimbursement for hospital inpatient services provided to Medi-Cal beneficiaries will be based on a new diagnosis-related group (DRG)-based methodology. The new payment system will use the All-Patient Refined DRGs (APR-DRGs) algorithm. As part of the transition, all restrictions based on the Selective Provider Contracting Program will no longer be in effect after July 1, 2013. Hospitals will no longer be designated as contract or non-contract facilities, and the previous designation of “closed health facility planning areas” will no longer be applicable. Also, any hospital that does not yet have an APR-DRG data-use agreement with the Department of Health Care Services is encouraged to e-mail to initiate that process. Further details regarding the transition to the APR-DRG payment system can be found at