California Welfare and Institutions Code ARTICLE 5.230 - Medi-Cal Hospital Reimbursement Improvement Act of 2013

• Section 14169.50.
  The Legislature finds and declares all of the following:(a) The Legislature continues to recognize the essential role that hospitals play in serving the state’s Medi-Cal beneficiaries....
• Section 14169.51.
  For purposes of this article, the following definitions shall apply:(a) “Acute psychiatric days” means the total number of Medi-Cal specialty mental health service administrative days, Medi-Cal...
• Section 14169.52.
  (a) There shall be imposed on each general acute care hospital that is not an exempt facility a quality assurance fee, except that a quality assurance...
• Section 14169.53.
  (a) (1) All fees required to be paid to the state pursuant to this article shall be paid in the form of remittances payable to the department.(2) The...
• Section 14169.54.
  (a) Private hospitals shall be paid supplemental amounts for each subject fiscal quarter in a program period for the provision of hospital outpatient services as set...
• Section 14169.55.
  (a) Private hospitals shall be paid supplemental amounts for the provision of hospital inpatient services for each subject fiscal quarter in a program period as set...
• Section 14169.56.
  (a) The department shall increase capitation payments to Medi-Cal managed health care plans for each subject fiscal year as set forth in this section.(b) (1) Subject to the...
• Section 14169.57.
  (a) Each managed health care plan receiving increased capitation payments under Section 14169.56 shall expend the capitation rate increases in a manner consistent with actuarial certification,...
• Section 14169.58.
  (a) (1) For the first program period, designated public hospitals shall be paid direct grants in support of health care expenditures, which shall not constitute Medi-Cal payments,...
• Section 14169.59.
  (a) The department shall determine during each rebase calculation year the number of subject fiscal years in the next program period.(b) During each rebase calculation year, the...
• Section 14169.60.
  (a) The amount of any payments made under this article to private hospitals, including the amount of payments made under Sections 14169.54 and 14169.55 and additional...
• Section 14169.61.
  (a) (1) Except as provided in this section, all data and other information relating to a hospital that are used for the purposes of this article, including,...
• Section 14169.62.
  Notwithstanding any provision in this article, the director may correct any identified material and egregious errors in the data, including, but not limited to, the...
• Section 14169.63.
  (a) Notwithstanding any other provision of this article requiring federal approvals, the department may impose and collect the quality assurance fee and may make payments under...
• Section 14169.64.
  (a) Notwithstanding any other provision in this article, the director may modify any timeline or timelines related to the assessment of the quality assurance fee or...
• Section 14169.65.
  (a) Upon receipt of a letter that indicates likely federal approval that the director determines is sufficient for implementation under Section 14169.63, or upon the receipt...
• Section 14169.66.
  The department shall make disbursements from the fund consistent with the following:(a) Fund disbursements shall be made periodically within 15 days of each date on which...
• Section 14169.67.
  Notwithstanding any other provision of this article, supplemental payments or other payments under this article shall only be required and payable in any quarter for...
• Section 14169.68.
  (a) In order to ensure that the proceeds of the quality assurance fee, the matching amount provided by the federal government, and any interest earned on...
• Section 14169.69.
  (a) The director shall do all of the following:(1) Promptly submit any state plan amendment or waiver request that may be necessary to implement this article.(2) Promptly seek...
• Section 14169.70.
  Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this...
• Section 14169.71.
  Notwithstanding any other provision of this article, the director may proportionately reduce the amount of any supplemental payments or increased capitation payments under this article...
• Section 14169.72.
  This article shall become inoperative if any of the following occurs:(a) The effective date of a final judicial determination made by any court of appellate jurisdiction...
• Section 14169.73.
  In the event this article becomes inoperative pursuant to Section 14169.72, all of the following shall apply:(a) No hospital shall be required to pay the fee...
• Section 14169.74.
  Beginning with the proposed budget for the 2014–15 fiscal year, and each fiscal year thereafter, the Department of Finance shall report in the Governor’s proposed...
• Section 14169.75.
  Notwithstanding subdivision (k) of Section 14167.35, subdivisions (a), (i), and (j) of Section 14167.35, creating the fund, are not repealed and shall remain operative as...
• Section 14169.76.
  This article is repealed on January 1 of the year following the date on which the article becomes inoperative.(Added by Stats. 2013, Ch. 657, Sec....

Last modified: October 22, 2018