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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more
California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

21-388 Acute Hospital Care at Home Program

Date: 05/28/21

Give acute care inpatient services at home to increase hospital capacity

The California Department of Public Health established state policies and procedures for the creation and oversight of the Acute Hospital Care at Home program during the COVID-19 public health emergency. Refer to the All Facilities Letter (AFL) 20-90 for hospitals on December 23, 2020.

Apply for a CMS waiver to participate in the program

Hospitals must individually apply for a Centers for Medicare & Medicaid Services (CMS) waiver before they can give approved acute care inpatient services to eligible California Health & Wellness Plan (CHWP) members at home. To apply, use the CMS online waiver application portal. Hospitals must submit the waiver request for individual CMS Certification Numbers, not entire systems.

Learn more about how to qualify for a waiver from the Department of Health Care Services (DHCS) All Plan Letter (APL) 20-021 (PDF) (revised).

Once the hospital receives an approved waiver from CMS –  

  • It can be used for the duration of the program. Note: This is not a blanket waiver.
  • Contact Dr. Shawn Hamilton, regional medical director, to discuss the hospital’s program and how to report members in the program.

Submit a notice of admission

Authorization from CHWP or its delegated independent practice associations is required for medically necessary acute care inpatient services at home. Notification of the admission submitted to CHWP must reference that the member is accessing the benefit using home care.

Hospital rates and monthly reporting

Contracted hospitals with an approved program waiver:

  • The same rates for inpatient acute care services in a traditional hospital setting are paid for the Acute Hospital Care at Home program.  
  • On a monthly basis, participating hospitals will be contacted for the number of CHWP members receiving services in the Acute Hospital Care at Home program. This information is submitted to DHCS.

Additional information

For more information about the program and a list of California hospitals approved to offer acute hospital care at home services, go to the DHCS website.

Providers are encouraged to access CHWP’s provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions about the information contained in this update, contact CHWP at 877-658-0305.