California Welfare and Institutions Code ARTICLE 5.2 - Medi-Cal Hospital Care/Uninsured Hospital Care Demonstration Project Act
- Section 14166.
(a) This article shall be known and may be cited as the “Medi-Cal Hospital/Uninsured Care Demonstration Project Act.”(b) The Legislature finds and declares all of the following:(1) The...
- Section 14166.1.
For purposes of this article, the following definitions shall apply:(a) “Allowable costs” means those costs recognized as allowable under Medicare reasonable cost principles and additional costs...
- Section 14166.2.
(a) The demonstration project, and the successor demonstration project, as applicable, shall be implemented and administered pursuant to this article.(b) (1) The director may modify any process or...
- Section 14166.3.
(a) During the demonstration project and successor demonstration project terms, payment adjustments to disproportionate share hospitals shall not be made pursuant to Section 14105.98. Payment adjustments...
- Section 14166.35.
(a) For each project year through October 31, 2010, designated public hospitals shall be eligible to receive the following:(1) Payments for Medi-Cal inpatient hospital services and supplemental...
- Section 14166.4.
(a) Notwithstanding Article 2.6 (commencing with Section 14081), and any other provision of law, fee-for-service payments to the designated public hospitals for inpatient services to Medi-Cal...
- Section 14166.5.
(a) With respect to each project year through October 31, 2010, the director shall determine a baseline funding amount for each designated public hospital. A hospital’s...
- Section 14166.6.
(a) For the 2005–06 project year and subsequent project years through October 31, 2010, each designated public hospital described in subdivision (c) of Section 14166.3 shall...
- Section 14166.61.
(a) For successor demonstration year 6 and subsequent successor demonstration years, each designated public hospital described in subdivision (c) of Section 14166.3 shall be eligible to...
- Section 14166.7.
(a) (1) With respect to each project year through October 31, 2010, designated public hospitals, or governmental entities with which they are affiliated, shall be eligible to...
- Section 14166.71.
(a) (1) With respect to each successor demonstration year, designated public hospitals, or governmental entities with which they are affiliated, shall be eligible to receive safety...
- Section 14166.75.
(a) For services provided during the 2005–06 and 2006–07 project years, the amount allocated to designated public hospitals pursuant to subparagraph (A) of paragraph (2) and...
- Section 14166.77.
(a) (1) The amount of delivery system reform incentive pool funding, consisting of both the federal and nonfederal share of payments, that is made available to each...
- Section 14166.8.
(a) Within five months after the end of each project year or successor demonstration year, each of the designated public hospitals shall submit to the department...
- Section 14166.9.
(a) The department, in consultation with the designated public hospitals, shall determine the mix of sources of federal funds for payments to the designated public hospitals...
- Section 14166.10.a.
(a) Payments to private hospitals under the demonstration project shall include, as applicable, all of the following:(1) Payments under selective provider contracts with the department negotiated by...
- Section 14166.11.
(a) The department shall pay to each project year private DSH hospital the amounts that would have been paid under the disproportionate share hospital program using...
- Section 14166.115.
(a) Due to the state budget deficit and in order to implement changes in the level of funding for health care services, the department shall reduce...
- Section 14166.12.
(a) The California Medical Assistance Commission shall negotiate payment amounts, in accordance with the selective provider contracting program established pursuant to Article 2.6 (commencing with Section...
- Section 14166.125.
(a) Effective the first fiscal year in which reimbursement to private hospitals is provided under the diagnosis-related group methodology established pursuant to Section 14105.28, the director...
- Section 14166.13.
(a) With respect to each project year, the director shall determine a baseline funding amount for each base year private DSH hospital that is also a...
- Section 14166.14.
The amount of any stabilization funding payable to the project year private DSH hospitals under Section 14166.20 for a project year, which amount shall not...
- Section 14166.15.
(a) Payments to nondesignated public hospitals under the demonstration project shall include, as applicable, the following:(1) Payments under selective provider contracts with the department negotiated by the...
- Section 14166.151.
(a) It is the intent of the Legislature to allow for a voluntary process for nondesignated public hospitals to claim reimbursement from the safety net care...
- Section 14166.16.
(a) The department shall pay to each nondesignated public hospital that is an eligible hospital for the project year, as determined under Section 14105.98, disproportionate share...
- Section 14166.17.
(a) The California Medical Assistance Commission shall negotiate payment amounts in accordance with the selective provider contracting program established pursuant to Article 2.6 (commencing with Section...
- Section 14166.18.
(a) With respect to each project year, the director shall determine a baseline funding amount for each nondesignated public hospital that was an eligible hospital under...
- Section 14166.19.
The amount of any stabilization funding payable to the nondesignated public hospitals under paragraph (4) of subdivision (b) of Section 14166.20 for a project year,...
- Section 14166.20.a.
(a) With respect to each project year through October 31, 2010, the total amount of stabilization funding shall be the sum of the following:(1) (A) Federal Medicaid funds...
- Section 14166.21.
(a) The Health Care Support Fund is hereby established in the State Treasury. Notwithstanding Section 13340 of the Government Code, the fund shall be continuously appropriated...
- Section 14166.22.
(a) To the extent required to maximize available federal funds under the demonstration project and to the extent authorized by the Special Terms and Conditions for...
- Section 14166.221.
(a) It is the intent of the Legislature for the department to maximize the receipt of federal funds for California’s Medi-Cal program, including this demonstration project,...
- Section 14166.225.
(a) In order to implement changes in the level of funding for health care services, the director shall reduce safety net care pool payments as specified...
- Section 14166.23.
(a) For purposes of this section, “distressed hospitals” are hospitals that participate in selective providers contracting under Article 2.6 (commencing with Section 14081) and that meet...
- Section 14166.24.
(a) Any determination of the amount due a designated public hospital that is based in whole or in part on costs reported to or audited by...
- Section 14166.25.
(a) The Legislature finds and declares all of the following:(1) In light of the closure of Los Angeles County Martin Luther King, Jr.-Harbor Hospital, there is a...
- Section 14166.252.
(a) In the event of a partial year extension of a demonstration project pursuant to this article, the director shall have discretion to determine allocations for...
- Section 14166.253.
(a) If the department has not received adequate assurances from the federal Centers for Medicare and Medicaid Services (CMS) before November 1, 2015, that the department’s...
- Section 14166.26.
(a) Unless this article is repealed pursuant to subdivision (b) or (g) of Section 14166.2, this article shall become inoperative on the date that the director...
Last modified: October 22, 2018