ARTICLE 5.2. Medi-Cal Hospital Care/Uninsured Hospital Care Demonstration Project Act

Article 5.2 added by Stats. 2005, Ch. 560, Sec. 1.

§§ 14166–14166.26 · 39 sections

§ 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…
§ 14166.1 For purposes of this article, the following definitions shall apply: (a) “Allowable costs” means those costs recognized as allowable under Medicare reasonable…
§ 14166.2 (a) The demonstration project, and the successor demonstration project, as applicable, shall be implemented and administered pursuant to this article. (b) (1)…
§ 14166.3 (a) During the demonstration project and successor demonstration project terms, payment adjustments to disproportionate share hospitals shall not be made…
§ 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…
§ 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…
§ 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…
§ 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…
§ 14166.61 (a) For successor demonstration year 6 and subsequent successor demonstration years, each designated public hospital described in subdivision (c) of 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…
§ 14166.71 (a) (1) With respect to each successor demonstration year, designated public hospitals, or governmental entities with which they are affiliated, shall be…
§ 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…
§ 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…
§ 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…
§ 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…
§ 14166.10 (a) Payments to private hospitals under the demonstration project shall include, as applicable, all of the following: (1) Payments under selective provider…
§ 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…
§ 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…
§ 14166.12 (a) The California Medical Assistance Commission shall negotiate payment amounts, in accordance with the selective provider contracting program established…
§ 14166.125 (a) Effective the first fiscal year in which reimbursement to private hospitals is provided under the diagnosis-related group methodology established pursuant…
§ 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 project…
§ 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…
§ 14166.15 (a) Payments to nondesignated public hospitals under the demonstration project shall include, as applicable, the following: (1) Payments under selective…
§ 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…
§ 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,…
§ 14166.17 (a) The California Medical Assistance Commission shall negotiate payment amounts in accordance with the selective provider contracting program established… see note
§ 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…
§ 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…
§ 14166.20 (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…
§ 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…
§ 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…
§ 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…
§ 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 in…
§ 14166.23 (a) For purposes of this section, “distressed hospitals” are hospitals that participate in selective providers contracting under Article 2.6 (commencing with…
§ 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 a Medicare fiscal…
§ 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…
§ 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…
§ 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…
§ 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…