Hla mus rau Cov Ntsiab Lus Tseem Ceeb​​ 

Tsev Kho Mob Tus Nqi Them Nqi Kho Mob​​ 

HQAF Program Overview​​ 

California Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau siv nws thawj qhov kev pabcuam Tus Nqi Kho Mob Zoo (HQAF) hauv xyoo 2010. Qhov kev zov me nyuam muab nyiaj pab them nqi ntxiv rau California cov tsev kho mob uas pab Medi-Cal thiab cov neeg mob tsis muaj kev pov hwm. Cov nyiaj tau los ntawm HQAF tseem muab nyiaj pab rau cov menyuam yaus kev kho mob, them nyiaj ncaj qha rau cov tsev kho mob pej xeem, thiab them rov qab DHCS rau cov nqi ncaj qha ntawm kev tswj hwm txoj haujlwm. Qhov kev zov me nyuam tau ua tiav zoo, muab ntau txhiab daus las hauv kev them nyiaj ntxiv rau California cov tsev kho mob. Qhov kev zov me nyuam tau ua tas mus li los ntawm txoj cai ntawm Proposition 52 hauv Kaum Ib Hlis 2016.​​ 

HQAF Program Kev Tsim Nyog​​ 

Rau lub tsev kho mob ntiag tug kom tsim nyog tau txais kev them nyiaj ntxiv cov cai hauv qab no yuav tsum tau ua raws, raws li tau teev tseg hauv Welfare and Institutions (W&I) Code §14169.51 subdivision (ap):​​ 

  • Muaj ntawv tso cai raws li subdivision (a) ntawm Tshooj 1250 ntawm Txoj Cai Kev Noj Qab Haus Huv thiab Kev Nyab Xeeb.​​ 
  • Yog nyob rau hauv Charitable Research Hospital cov phooj ywg, raws li tau teev tseg nyob rau hauv 1991 Tsev Kho Mob Peer Grouping Report luam tawm los ntawm lub tuam tsev, los yog tsis raug xaiv los ua ib lub tsev kho mob tshwj xeeb nyob rau hauv lub tsev kho mob cov ntaub ntawv nyuam qhuav tshaj tawm Office of Statewide Health Planning and Development Annual Financial Disclosure Report, raws li thawj hnub ntawm lub sijhawm ua haujlwm.​​ 
  • Tsis ua raws li Medicare cov txheej txheem los muab cais ua lub tsev kho mob mus sij hawm ntev.​​ 
  • Yog lub tsev kho mob uas tsis yog pej xeem, tsev kho mob uas tsis yog pej xeem hloov dua siab tshiab, lossis lub tsev kho mob hloov dua siab tshiab raws li cov ntsiab lus tau teev tseg hauv kab lus (26) txog (28), suav nrog, feem, ntawm subdivision (a) ntawm Tshooj §14105.98.​​ 
  • Tsis yog lub tsev kho mob pej xeem tsis raug xaiv los yog lub tsev kho mob pej xeem raug xaiv.​​ 

HQAF Fee Collections​​ 

Lub tuam tsev tau ntsuas tus nqi ntawm qee lub tsev kho mob hnyav uas yuav tsum tau siv, feem ntau, raws li tsoomfwv tsis yog tsoomfwv cov nyiaj pabcuam Medi-Cal ntxiv rau cov tsev kho mob tsim nyog rau cov kev pabcuam neeg mob hauv tsev thiab sab nraud. Cov nyiaj khaws cia tau muab tso rau hauv lub tsev kho mob cov nyiaj tau los ntawm cov nyiaj tau los.​​ 

HQAF Program Funding Calculations​​ 

Kev suav nyiaj txiag tau ua tiav los ntawm tus qauv nqi tsev kho mob. Tus qauv nqi tsev kho mob suav cov nqi thiab cov nyiaj them rau txhua lub tsev kho mob uas koom nrog los ntawm kev siv txhua lub tsev kho mob cov ntaub ntawv txhua hnub los txiav txim siab txog kev siv Medicaid tus nqi, tsoomfwv cov nyiaj them qis tshaj, thiab ntau lwm yam ntaub ntawv.​​ 

HQAF Change of Ownership (CHOW) Process​​ 

Cov tsev kho mob ntiav uas tau hloov pauv tswv cuab (CHOW) yuav tsum ua kom tiav cov txheej txheem CHOW uas tau piav qhia hauv 5/13/16 CHOW Tus Muab Kev Pabcuam tsis pub dhau 30 hnub txij li hnub tsab ntawv los ntawm Lub Xeev muab Medi-Cal Certification rau tus tswv tshiab ntawm lub tsev kho mob. Cov tswv tshiab tuaj yeem xa Daim Ntawv Pom Zoo Txog Nyiaj Txiag, tso cai rau lub tsev kho mob txuas ntxiv kev koom tes hauv cov nqi thiab kev them nyiaj ntawm HQAF qhov kev pab cuam, lossis ua kom tiav Daim Ntawv Pov Thawj, los ntawm lub tsev kho mob suav tias yog "Lub Tsev Kho Mob Tshiab" thiab tshem tawm tam sim no. HQAF program period. Yog xav paub ntxiv, thov xa email rau HQAF@dhcs.ca.gov. Txhawm rau kom ua tiav raws sijhawm, thov email ua tiav CHOW pob rau HQAF@dhcs.ca.gov.​​    

Tsev Kho Mob Quality Assurance Fee Program Models​​ 

HQAF VIII Tus Nqi & Them Nqi (CY 2023 & 2024)​​ 
HQAF VII Fee & Payment Model (CY 2022)​​ 
HQAF VI Fee& Payment Model (SFY 2019-2022)
HQAF V Fee & Payment Model (SFY 2017-2019)
​​ 
Private Hospital Inpatient UPLs - CY 2022
Private Hospital Outpatient UPLs - CY 2022
Private Hospital Inpatient UPLs - SFY 2017-18 & 2018-19
Private Hospital Outpatient UPLs - 7 SFY-1 SFY 2018-19
Private Hospital Inpatient UPL - SFY 2016-17
Private Hospital Outpatient UPL - SFY 2016-17

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(Yog tias koj xav tau ib daim qauv ntawm HQAF Them Nyiaj Limit thiab/lossis Tus Nqi & Cov Qauv Them Nqi, thov email HQAF@dhcs.ca.gov)
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Yuav tiv tauj peb li cas​​ 

Kev sau nqi thiab cov ntaub ntawv them nqi-rau-kev pabcuam yog nyob rau ntawm Third Party Liability & Recovery Division lub vev xaib.​​ 

Cov lus nug txog kev pab cuam yuav tsum raug xa mus rau HQAF@dhcs.ca.gov​​ 

Lub Xeev Txoj Kev Hloov Kho​​ 
Hnub hloov tshiab kawg: 1/3/2025 3:01 PM​​