23-787 Acute Hospital Care at Home Program Extends Through 2024

Date: 07/31/23

Give acute care inpatient services at home to increase hospital capacity

On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act of 2023. This legislation included an extension of the Acute Hospital Care at Home program waiver that was initiated during the federal public health emergency.

The Acute Hospital Care at Home program has been extended to December 31, 2024. Refer to All-Plan Letter (APL) 20-021 (Revised) for hospitals dated April 19, 2023.

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 Medi-Cal 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) APL 20-021 (Revised):

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

Submit a notice of admission

Authorization from California Health & Wellness Plan (CHPW) 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 Medi-Cal members receiving services in the Acute Hospital Care at Home program. This information is submitted to DHCS.

Additional information

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 regarding the information contained in this update, contact CHWP at 877-658-0305.

 

This Information applies to Independent Practice Associations, and Hospitals.