Medi-Cal: hospitals: reimbursements.

Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which basic health care services are provided to qualified low-income persons. Existing law, until January 1, 2013, reduces interim payments by 10% for inpatient hospital services provided on and after July 1, 2008, at all hospitals that receive Medi-Cal reimbursement from the department and that are not under selective contracts with the department. Under existing law, beginning on October 1, 2008, amounts paid to hospitals that are calculated pursuant to the above provisions shall not exceed the applicable regional average per diem contract rate for tertiary hospitals and for certain other hospitals, reduced by 5%, multiplied by the number of Medi-Cal covered inpatient days for which the interim payment is being made. Existing law provides that regional average per diem contract rate limitation shall not apply to open health facility planning areas when any of specified conditions is met, including when the open health facility planning area has 3 or more hospitals with licensed general acute care beds. This bill would require that these 3 or more hospitals be full service hospitals. The bill would define full service hospital as being a general acute care hospital which, at a minimum, provides basic emergency medical services, medical or surgical services, intensive care services, and perinatal services. This bill would declare that it is to take effect immediately as an urgency statute.