CHA News Article

Waiver to Modify Hospital Admissions Process Approved
Applies to Medi-Cal fee-for-service beneficiaries

The Centers for Medicare & Medicaid Services this week approved the Superior Systems Waiver (SSW) renewal application, effective for the period from Oct. 1, 2015 through Sept. 30, 2017. The SSW describes the utilization review process for acute inpatient hospitals that serve fee-for-service Medi-Cal patients. It also specifies how non-designated public hospitals and private hospitals will transition from using the current treatment authorization requests to using their own utilization management systems based on nationally recognized, evidence-based medical criteria. Under a previous waiver, California’s 21 designated public hospitals have piloted this new method. More information is available in CHA’s article on the proposed waiver, and the approved waiver is available on the DHCS website