Tus kws kho mob uas tsis yog kws kho mob kws kho mob ntxiv qhov kev pab nyiaj rov qab
PNPP Program Overview
Tus Kws Kho Mob Tsis Muaj Tus Kws Kho Mob Tus Kws Kho Mob Ntxiv Qhov Kev Pab Them Nyiaj Rov Qab (PNPP) yog Certified Public Expenditure (CPE) program, uas muab nyiaj rov qab ntxiv rau cov tsev kho mob uas tsim nyog tau txais los ntawm tsoomfwv lossis tsoomfwv cov koom haum, uas lawv koom nrog, rau cov nqi kho mob tsis tau them nqi kho mob thiab Cov kws kho mob tsis yog kws kho mob cov kev pabcuam rau cov neeg tau txais txiaj ntsig Medicaid.
California State Plan Amendment (SPA) No. 05-023, pib lub Xya hli ntuj 1, 2005, thiab tau pom zoo los ntawm Centers for Medicare & Medicaid Services (CMS) nyob rau lub Kaum Ob Hlis 21, 2007, piav qhia txog cov txheej txheem them rov qab ntxiv rau tus kws kho mob thiab cov kws kho mob uas tsis yog kws kho mob. cov nqi tshaj lij.
SPA 16-020, siv tau rau lub Xya Hli 1, 2016, thiab tau txais kev pom zoo los ntawm CMS rau lub Kaum Ob Hlis 6, 2016, tau hloov kho cov lus ntawm Txoj Kev Npaj ntawm Lub Xeev kom qhia txog cov npe tam sim no ntawm cov neeg koom nrog hauv Tsev Kho Mob Pej Xeem (DPH) thiab los suav nrog txhua qhov kev hloov pauv lub npe tsev kho mob yav tom ntej.
SPA 24-0026, siv tau rau lub Plaub Hlis 1, 2024, thiab tau txais kev pom zoo los ntawm CMS rau lub Kaum Ob Hlis 16, 2024, hloov SPAs 05-023 thiab 16-020 nrog kev hloov kho rau txoj kev them nyiaj ntxiv rau tus nqi ntawm cov kev pabcuam tshaj lij ntawm tsoomfwv cov tsev kho mob sab nraud.
Daim Ntawv Ntxiv ntawm Txoj Kev Npaj ntawm Lub Xeev 4.19-B, nplooj ntawv 52-63 (SPAs 05-023, 16-020, thiab 24-0026) piav qhia txog cov kev cai them rov qab ntxiv, cov DPHs uas tsim nyog, thiab cov txheej txheem them rov qab. Txoj Kev Npaj ntawm Lub Xeev tso cai rau Txoj Kev Npaj Siv Kev Kawm Txog Lub Sijhawm, uas piav qhia txog txoj kev kawm txog lub sijhawm kom ntxaws ntxiv.
Kev tshawb fawb sij hawm yuav tsum tau suav rau 100% ntawm cov kws kho mob lub sijhawm ntawm cov kws kho mob hauv qab no hauv cov chaw hauv qab no suav nrog txog li 4 tus nqi sib cais:
- University of California (UC) kev teeb tsa (tus kws kho mob)
- Kev teeb tsa UC (cov kws kho mob tsis yog kws kho mob)
- Kev teeb tsa tsis yog UC (cov kws kho mob tsis yog kws kho mob)
- Kev teeb tsa tsis yog UC (Medicare pom zoo tshawb xyuas tus kws kho mob lub sijhawm)
PNPP Txoj Haujlwm Pabcuam Kev Tsim Nyog
The physician and non-physician practitioner costs are limited to professional costs incurred by the DPHs listed in Appendix 1 of Attachment 4.19-A of the State Plan, including any successor or differently named hospital, as applicable, and their affiliated government physician practice groups (i.e., practice group that is owned and operated by the same government entity that owns and operates the hospital). These professional costs are reported on the DPHs’ Medi-Cal 2552 cost report and, in the case of the UC hospitals, the UC School of Medicine physician/non-physician practitioner cost report as approved by CMS.
Kev them nyiaj rov qab PNPP
Cov nyiaj them ntxiv ntawm PNPP kwv yees li qhov sib txawv ntawm kev them nqi rau Kev Pabcuam (FFS) thiab cov nqi Medicaid uas tso cai rau cuam tshuam nrog cov kws tshaj lij ntawm cov kws kho mob lossis cov kev pabcuam tsis yog kws kho mob uas tsim nyog rau Kev Koom Tes Nyiaj Txiag ntawm Tsoomfwv Tebchaws (FFP). Cov nyiaj them ntxiv rau PNPP raug them txhua xyoo raws li tau piav qhia hauv Daim Ntawv Qhia Txog Lub Xeev 4.19-B, nplooj ntawv 52-63 (SPAs 05-023, 16-020, thiab 24-0026) thiab Daim Ntawv Qhia Txog Kev Siv Sijhawm Kawm.
Yuav tiv tauj peb li cas
Yog tias koj muaj lus nug ntxiv, xa cov lus nug rau: PNPP@dhcs.ca.gov