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</xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </head> <body bgcolor="#FAFAFA" lang=EN-US link=blue vlink=purple style='tab-interval: .5in' leftmargin=0 marginwidth=0 topmargin=0 marginheight=0 offset=0> <div class=WordSection1> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;background:#FAFAFA;border-collapse:collapse;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='padding:0in 0in 0in 0in'> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=600 style='width:6.25in;background:#FAFAFA;border-collapse:collapse;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='padding:7.5pt 7.5pt 7.5pt 7.5pt'> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;mso-yfti-tbllook: 1184;mso-padding-alt:7.5pt 7.5pt 7.5pt 7.5pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style='padding:7.5pt 7.5pt 7.5pt 7.5pt'></td> </tr> </table> </td> </tr> <!-- // End Module: Standard Preheader \ --> </table> </div> <p class=MsoNormal align=center style='text-align:center'><span style='mso-fareast-font-family:"Times New Roman";display:none;mso-hide:all'><o:p>&nbsp;</o:p></span></p> <!-- // End Template Preheader \\ --> <div align=center> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 width=600 style='width:6.25in;background:white;border-collapse:collapse;border:none; mso-border-alt:solid #DDDDDD .75pt;mso-yfti-tbllook:1184;mso-padding-alt: 0in 0in 0in 0in' id=templateContainer> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=top style='border:solid #DDDDDD 1.0pt;border-bottom:none; mso-border-top-alt:solid #DDDDDD .75pt;mso-border-left-alt:solid #DDDDDD .75pt; mso-border-right-alt:solid #DDDDDD .75pt;padding:0in 0in 0in 0in'><!-- // Begin Template Header \\ --> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=600 style='width:6.25in;background:white;border-collapse:collapse;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in' id=templateHeader> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style='padding:0in 0in 0in 0in'><!-- // Begin Module: Standard Header Image \\ --> <p class=MsoNormal align=center style='text-align:center'><a href="http://medi-cal.ehr.ca.gov/" target="_blank"><span style='font-size:25.5pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:#336699;mso-no-proof:yes;text-decoration:none; text-underline:none'><img border=0 width=600 height=156 id="_x0000_i1026" src="http://www.dhcs.ca.gov/provgovpart/Documents/OHIT/email_images/header.gif" alt="Description: California Department of Health Care Services"></span></a><b><span style='font-size:25.5pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:#202020'><o:p></o:p></span></b></p> </td> </tr> </table> </div> </td> </tr> <!-- // End Template Header \\ --> <tr style='mso-yfti-irow:1'> <td valign=top style='border-top:none;border-left:solid #DDDDDD 1.0pt; border-bottom:none;border-right:solid #DDDDDD 1.0pt;mso-border-left-alt: solid #DDDDDD .75pt;mso-border-right-alt:solid #DDDDDD .75pt;padding:0in 0in 0in 0in'><!-- // Begin Template Body \\ --> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=600 style='width:6.25in;border-collapse:collapse;mso-yfti-tbllook:1184; mso-padding-alt:0in 0in 0in 0in' id=templateBody> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='background:white;padding:0in 0in 0in 0in'><!-- // Begin Module: Standard Content \\ --> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;mso-yfti-tbllook: 1184;mso-padding-alt:15.0pt 15.0pt 15.0pt 15.0pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='padding:15.0pt 15.0pt 15.0pt 15.0pt'> <p class=MsoNormal style='line-height:150%'><span style='font-size: 10.5pt;line-height:150%;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:#505050'>September 20, 2011<br> <br> <strong><span style='font-family:"Arial","sans-serif"'>Notice to Hospital Representatives,</span></strong> <br> <br> It has come to our attention that some hospitals in California do not use the CMS 2552-96 form according to CMS instructions when reporting on Medi-Cal services. Many comply with supplemental instructions issued by DHCS that require reporting of contract services in column 3 (designated for Medicare Title V by CMS). Also, these supplemental instructions state that Medi-Cal managed care bed days should not be reported on the form. CMS provides line 2 (HMO) for this purpose.<br> <br> The data sources identified on the Hospital Workbook assume compliance with CMS instructions. To deal with these disparities we are issuing the following instructions:<o:p></o:p></span></p> <ul type=disc> <li class=MsoNormal style='color:#505050;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;line-height:150%;mso-list:l0 level1 lfo1; tab-stops:list .5in'><span style='font-size:10.5pt;line-height: 150%;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman"'>In calculating Total Medicaid Inpatient Bed Days, if managed care bed days have not been reported on the CMS 2552-96 form in Line 2, Column 5, the Medi-Cal managed care bed days reported on the OSHPD Annual Hospital Financial Report should be used instead. Specifically, the amount in Section 4.1, line 5, column 4, of the Patient Census Days table of the OSHPD report may be used. Please upload a copy of the appropriate OSHPD report page with your application if your hospital will be using this data source.<o:p></o:p></span></li> </ul> <p class=MsoNormal style='margin-left:.5in;line-height:150%'><span style='font-size:10.5pt;line-height:150%;font-family:"Arial","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#505050'><o:p>&nbsp;</o:p></span></p> <ul type=disc> <li class=MsoNormal style='color:#505050;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;line-height:150%;mso-list:l0 level1 lfo1; tab-stops:list .5in'><span style='font-size:10.5pt;line-height: 150%;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman"'>If column 3 of the CMS 2552-96 form has been used to report contractual services, the amounts in this column may be added to the relevant column 5 (Title XIX) amounts to establish Total Medicaid Inpatient Bed Days. If Medicare Title V funding has been used for any bed days reported in column 3, these must be excluded before adding to column 5.<o:p></o:p></span></li> </ul> <p style='line-height:150%'><span style='font-size:10.5pt;line-height: 150%;font-family:"Arial","sans-serif";color:#505050'>The hospital workbook has been updated to reflect these new instructions and can be accessed <a href="http://www.dhcs.ca.gov/provgovpart/Documents/OHIT/Hospital_Eligibility_Workbook.xls"><span style='color:#336699'>HERE</span></a>. <o:p></o:p></span></p> </td> </tr> </table> <!-- // End Module: Standard Content \\ --></td> </tr> </table> </div> <!-- // End Template Body \\ --></td> </tr> <tr style='mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td valign=top style='border:solid #DDDDDD 1.0pt;border-top:none; mso-border-left-alt:solid #DDDDDD .75pt;mso-border-bottom-alt:solid #DDDDDD .75pt; mso-border-right-alt:solid #DDDDDD .75pt;padding:0in 0in 0in 0in'><!-- // Begin Template Footer \\ --> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=600 style='width:6.25in;background:white;border-collapse:collapse;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in' id=templateFooter> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='padding:7.5pt 7.5pt 7.5pt 7.5pt'><!-- // Begin Module: Standard Footer \\ --> <p class=MsoNormal><a href="http://www.dhcs.ca.gov/Pages/dhcsohit.aspx" target="_blank"><span style='mso-fareast-font-family:"Times New Roman"; mso-no-proof:yes;text-decoration:none;text-underline:none'><img border=0 width=600 height=99 id="_x0000_i1025" src="http://www.dhcs.ca.gov/provgovpart/Documents/OHIT/email_images/footer.gif" alt="Description: California Department of Health Care Services"></span></a><span style='mso-fareast-font-family:"Times New Roman"'><o:p></o:p></span></p> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;mso-yfti-tbllook: 1184;mso-padding-alt:7.5pt 7.5pt 7.5pt 7.5pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td width=350 valign=top style='width:262.5pt;padding:7.5pt 7.5pt 7.5pt 7.5pt'> <p style='line-height:125%'><span style='font-size:9.0pt;line-height: 125%;font-family:"Arial","sans-serif";color:#707070'>California Department of Health Care Services<br> <a href="http://www.dhcs.ca.gov/Pages/dhcsohit.aspx" target="_blank"><span style='color:#336699'>Office of Health Information Technology</span></a><br> 1501 Capitol Avenue, MS0004<br> Sacramento, CA 95814<br> (916) 552-9181 <o:p></o:p></span></p> </td> <td width=190 valign=top style='width:142.5pt;padding:7.5pt 7.5pt 7.5pt 7.5pt' id=""> <p style='line-height:125%'><strong><span style='font-size:9.0pt; line-height:125%;font-family:"Arial","sans-serif";color:#707070'>Email:</span></strong><span style='font-size:9.0pt;line-height:125%;font-family:"Arial","sans-serif"; color:#707070'> <br> <a href="mailto:EHPrequal@dhcs.ca.gov"><span style='color:#336699'>EHPrequal@dhcs.ca.gov</span></a> <br> <a href="http://twitter.com/#!/EHRincentiveCA" target="_blank"><span style='color:#336699'>Follow us on Twitter</span></a> <o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td colspan=2 style='background:white;padding:7.5pt 7.5pt 7.5pt 7.5pt' id=utility></td> </tr> </table> </td> </tr> <!-- // End Module: Standard Footer \\ --> </table> </div> </td> </tr> <!-- // End Template Footer \\ --> </table> </div> <p class=MsoNormal align=center style='margin-bottom:12.0pt;text-align:center'><span style='mso-fareast-font-family:"Times New Roman"'><br> <br style='mso-special-character:line-break'> <![if !supportLineBreakNewLine]><br style='mso-special-character:line-break'> <![endif]><o:p></o:p></span></p> </td> </tr> </table> </div> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> </div> </body> </html>