July 20’s Hospital Fee Program Status Report, co-hosted by the California Hospital Association and HASC in Los Angeles, drew close to 100 attendees eager for the latest on California’s Medi-Cal reimbursement for hospitals.

Led by Anne McLeod, CHA’s senior vice president for health policy and innovation, the presentation included a detailed picture from Amber Ott, CHA’s vice president for strategic financing initiatives.

“The bottom line is that the fee program is one the highest-priority issues for members right now,” said George W. Greene, HASC president and CEO.

As outlined by CHA, the state’s hospital fee program is crucial for California’s entire safety net, which is why California’s safety-net hospitals initiated legislation related to the issue with full support of all California hospitals. The program uses hospital fees assessed by the state to draw down federal matching funds, which are then issued as supplemental payments to hospitals. The fee program is an integral element to improving access to health care for some of California’s most vulnerable residents. Initiated in 2009 (AB 1383), the fee program and its statutory provisions and protections were made permanent through CHA’s 2016 ballot initiative, the Medi-Cal Funding and Accountability Act (Proposition 52). By removing the sunset date of Jan. 1, 2018, the Act provides the framework for all future hospital fee programs. Among other statutory provisions, Proposition 52 makes permanent the limit on the amount the state can take out of the program for the General Fund, the construct of the fee program (both the fee side and the payment mechanisms) and the source of data and information used to develop the program.

The current program period began on Jan. 1 and runs through June 30, 2019. Each subsequent program period will cover two to three years, depending on future circumstances.

At the July 20 meeting, McLeod outlined negotiations between CHA, the state Department of Health Care Services (DHCS) and the federal Centers for Medicare & Medicaid Services (CMS). While dealing with procedural details, the talks resulted in increased “flexibility for interpreting these rules,” McLeod reported.

The complexity surrounding the fee program is such that meeting attendees spent close to an hour in give-and-take with McLeod and Ott to understand details.

The result, one attendee said, was a more detailed picture.

“I think you’ve done a brilliant job of bringing clarity to something that’s not always clear,” said Kenn McFarland, CEO at Fountain Valley Regional Medical Center.

McLeod responded that maximizing payments to members is her top priority as she continues to wrestle with the issue.

“I am always fueled by getting the most money to (hospitals) as possible,” she told the group. “And to not deferring and not delaying.”

Contact:
Isela Rivas
(213) 538-0704
irivas@hasc.org