Medi-Cal is California's Medicaid program — a public health insurance program that provides needed health care services for low-income families with children, seniors, people with disabilities, foster caregivers, pregnant women and low-income people with specific diseases, such as tuberculosis, breast cancer or HIV/AIDS. Medi-Cal is financed equally by the state and federal governments.
Medi-Cal is California’s Medicaid program — a public health
insurance program that provides needed health care services for
low-income families with children, seniors, people with
disabilities, foster caregivers, pregnant women and low-income
people with specific diseases, such as tuberculosis, breast
cancer or HIV/AIDS. Medi-Cal is financed equally by the state and
A total of 302 members of Congress signed on to a
bipartisan House letter urging Congress to delay cuts to
Medicaid disproportionate share hospitals for at least two
years. An overwhelming majority — 48 of 53 — of members
of the California delegation cosigned the letter. CHA
strongly supports this bipartisan effort and thanks members for
their engagement on this critical issue.
As of April 1, 26 counties were approved to deliver Drug Medi-Cal
Organized Delivery System (DMC-ODS) services, representing nearly
88 percent of the Medi-Cal population statewide. Fourteen
additional counties are in various phases of implementation.
Yesterday, CHA issued a
news release on Gov. Newsom’s revised 2019-20 state budget.
CHA applauds the Governor for making investments that improve
Californians’ health and well-being, including: ongoing support
for expanding Medi-Cal coverage to young adults, regardless of
immigration status; imposing a state-level individual coverage
mandate; broader premium subsidies for low and middle-income
families; and significant investments in behavioral health.
On Feb. 28, the Centers for Medicare & Medicaid Services (CMS)
approved the Home- and Community-Based Services Assisted Living
Waiver (ALW) renewal, effective March 1, 2019, through Feb. 28,
2024. The renewal includes 2,000 slots added in the CMS-approved
amendment from October 2018, for a total capacity of 5,744.
On May 21 at 11 a.m. (PT) and May 23 at 2 p.m. (PT), the
Department of Health Care Services (DHCS) will host a webinar
explaining upcoming changes to diagnosis-related group (DRG)
policies that will be implemented for state fiscal year 2019-20.
To register, email DRG@dhcs.ca.gov; once approved, DHCS
will send instructions for joining the webinar.
The Department of Health Care Services (DHCS) last week received
federal approval of a three-year extension of its Cal MediConnect
(CMC) program, which provides coordinated services to patients
who are dually eligible for Medicare and Medicaid.
The Department of Health Care Services earlier this week
announced how it will distribute the Governor’s $100 million
budget allocation to support active Whole Person Care pilot
programs that provide housing services, as well as its
methodology for determining the distributed amounts.
Today, CHA member hospitals participated in a lobby action day in Sacramento to encourage legislators to ask the administration to reset the calculation of Proposition 55 funds. During the event, 20 hospital leaders met with key legislators and their staff, urging them to support the voters’ intent and direct crucial health care funding to Medi-Cal.
Both the Medicare Payment Advisory Commission (MedPAC) and the
Medicaid and CHIP Payment and Access Commission (MACPAC) have
issued their March 2019 reports to Congress, based on
recommendations approved at their January meetings. The
MedPAC report evaluates Medicare payment issues, while the
MACPAC report recommends — among other items — that if
planned Medicaid disproportionate share hospital (DSH) cuts
proceed, they should be phased-in to give states and hospitals
more time to respond.
Earlier this week, CHA attended a Senate Health Committee
informational hearing that examined strategies across all
purchasers and programs that have the objective of improving the
care delivered to people with chronic conditions.
informational series from the California Health Care
Foundation explains various facets of the Medi-Cal program,
including a program overview, challenges of program
eligibility and enrollment, the process and challenges of
payments to Medi-Cal managed care plans, the 2019 edition of
Medi-Cal facts and figures, the intersection of Medi-Cal and
behavioral health, and the Medi-Cal budget process.
Twenty-four counties have now been approved to deliver services
through the Drug Medi-Cal Organized Delivery System Waiver,
according to a recent update from the Department of Health Care
Services (DHCS), with 16 additional counties in various phases of
The Department of Health Care Services (DHCS) has released
All Plan Letter 19-002, which details reporting requirements
for Medi-Cal managed care health plans (MCPs) during the annual
network certification process.
CHA submitted the attached comment letter responding to the
Centers for Medicare & Medicaid Services’ (CMS)
proposed rule that would change managed care regulations for
Medicaid and the Children’s Health Insurance Program (CHIP).
While most of the rule’s proposals are technical adjustments or
changes that have little impact on the Medi-Cal managed care
program, some could impact the managed care portion of the
Hospital Fee Program.
Yesterday, the Department of Health Care Services (DHCS) shared
four approval letters. dated Dec. 12, from the Centers for
Medicare & Medicaid Services (CMS). Hospitals should share
the relevant letters, linked here, with their accounting firms:
CHA has submitted a joint
comment letter responding to the Department of Health Care
Services’ (DHCS) draft All Plan Letter and Provider Bulletin that
address duplicate discounts within the 340B Drug Pricing Program.
study by researchers at University of California,
Berkeley and University of California, Los Angeles projects
up to 4.4 million Californians could be uninsured in 2023 because
of the federal law removing the Affordable care Act’s (ACA)
individual mandate penalty beginning in 2019.
According to a recent update from the Department of Health Care
Services, 19 counties — representing nearly 75 percent of the
Medi-Cal population — are currently approved to deliver Drug
Medi-Cal Organized Delivery System (DMC-ODS) services. The
DMC-ODS waiver is a voluntary pilot program that offers
California counties the opportunity to expand access to care for
Medi-Cal enrollees with substance use disorders.
Providers are reminded that they can now use their secure
Medi-Cal login to view and download PDF versions of remittance
advice details (RADs) and Medi-Cal financial summaries
RADs, along with their embedded financial summary information,
are available online sooner than in paper versions. The site
offers up to six calendar weeks of current RADs for immediate
download. Historical RADs in PDF dating back to April
2017 are available on the Medi-Cal website; a larger
database will be built over time. When complete, three years of
historical RADs will be available within one business day of a
Providers may submit printed versions of the online RADs as
supporting documentation with claims inquiry and appeal
The Centers for Medicare & Medicaid Services (CMS) announced in
the attached memo that its interpretive guidance for helping to
reduce suicide and self-harm in health care facilities will
include The Joint Commission’s
ligature risk recommendations. CMS states in the memo that,
until it releases its guidance, state survey agencies and
accrediting organizations “may use their judgment as to the
identification of ligature and other safety risk deficiencies,
the level of citation for those deficiencies, as well as the
approval of the facility’s corrective action and mitigation plans
to minimize risk to patient safety and remedy the identified
The American Society for Health Care Engineering, a professional
membership group of the American Hospital Association, has
tools and resources to help hospitals address ligature risk
and patient safety.