Hla mus rau Cov Ntsiab Lus Tseem Ceeb​​ 

Affordable Care Act (ACA) Cov Ntaub Ntawv​​ 

Cov ntaub ntawv pov thawj thib ob rau kev them nyiaj rov qab rau cov nqi ntxiv vim ACA Tus tswv ntiav ua haujlwm tau tshaj tawm txoj haujlwm​​ 

Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom muab cov chaw tshwj xeeb them nyiaj rov qab los ntawm kev ntxiv rau Medi-Cal cov nyiaj them rov qab rau tus nqi ntxiv ntawm kev saib xyuas kev noj qab haus huv nkaus xwb vim tus tswv hauj lwm sib koom ua lub luag haujlwm hauv ACA embodied hauv Tshooj 4980H ntawm Internal Revenue Code (IRC).​​ 
Pib txij xyoo 2016 – 2017 Rate Year, Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom muab cov nyiaj them rov qab tshwj xeeb rau qhov chaw.​​   Ib tus kws kho mob tuaj yeem xa Daim Ntawv Pov Thawj Thib Ob rau kev them nyiaj rov qab yog tias nws tsis yog Tus Neeg Ua Haujlwm Loj (ALE) hauv xyoo 2015, tab sis xyoo 2016, nws tau dhau los ua Tus Neeg Ua Haujlwm Loj Loj raws li tau hais los ntawm tshooj 4980H thiab nws cov kev cai siv, thiab yog tias tus neeg muab kev pabcuam raug nqi ntxiv vim qhov yuav tsum tau ACA no.  Tus kws kho mob kuj tseem tuaj yeem xa Daim Ntawv Pov Thawj Thib Ob nrog qhov sib txawv tiag tiag hauv 2016 cov nqi pov hwm tau tshwm sim yog tias nws yog Tus Neeg Ua Haujlwm Loj Tshaj Plaws hauv 2015 thiab xa thawj daim ntawv pov thawj ACA.​​ 
 
DHCS tsis lees txais cov lus thov ntxiv lawm. Hnub kawg ntawm kev xa ntawv yog​​  Lub Ob Hlis 28, 2017​​ .​​ 
 
Qhov add-on yuav siv rau cov chaw hauv qab no:​​ 
  • Free-Standing Skilled Nursing Facilities Level B (NF-B)​​ 
  • Free-Sstanding Adult Subacute​​ 
  • Nursing Facilities Level A (NF-A)​​ 
  • Distinct-Part Nursing Facilities Level B (DP/NF-B)​​ 
  • Nyob deb nroog Swing txaj​​ 
  • Distinct-Part Adult Subacute​​ 
  • Distinct-Pab Pediatric Subacute​​ 
  • Dawb-Sawv Pediatric Subacute​​ 
  • Intermediate Care Facilities for the Developmentally Disabled (ICF/DD)​​ 
  • Intermediate Care Facilities for the Developmentally Disabled/Habilitative (ICF/DD-H)​​ 
  • Intermediate Care Facilities for the Developmentally Disabled/Nursing (ICF/DD-N)​​ 
 
Yuav kom tsim nyog tau txais ib qho ntxiv, cov kws kho mob yuav tsum xa Daim Ntawv Pov Thawj Thib Ob los xyuas kom meej tias tus tswv hauj lwm yog ALE raws li tau teev tseg los ntawm IRC Tshooj 4980H (thiab nws cov kev tswj hwm thiab kev taw qhia) thiab tau ua rau cov nqi kho mob ntxiv tsuas yog los ntawm ACA Employer Shared Responsibility. Qhov no yog ob xyoos ntxiv rau tus nqi kom txog rau thaum ACA tau txib cov nqi kho mob nyob rau hauv lub tsev kho mob daim ntawv tshaj tawm tus nqi.​​  
  • ACA Employer Shared Responsibility Second Certification Form Instructions (PDF)​​ 
  • ACA Employer Shared Responsibility Daim Ntawv Pov Thawj Thib Ob (EXCEL)​​ 
 
Cov kws kho mob tuaj yeem xa daim ntawv pov thawj hauv hluav taws xob rau​​  supp1629@dhcs.ca.gov​​  nrog lub ntsiab lus "​​ 2016-2017 ACA Daim Ntawv Pov Thawj​​ "nrog rau lawv lub chaw NPI lossis OSHPD tus lej (piv txwv li, "ACA Certification Form 206xxxxxx"). Cov kws kho mob uas tsis muaj peev xwm xa hluav taws xob tuaj yeem xa daim ntawv kos npe ntawm daim ntawv pov thawj rau:​​  

Department of Health Care Services​​ 
Tus Nqi-rau-Service Rate Development Division​​ 
Ntu Kev Kho Mob Ntev Ntev​​ 
ACA Daim Ntawv Pov Thawj Thib Ob​​ 
PO Box 997417, Ste. 71.3052, MS 4600​​ 
Sacramento, CA 95899-7417​​ 

Cov ntaub ntawv no yog vim DHCS tsis pub dhau Lub Ob Hlis 28, 2017. Yog xav tau kev pab, cov kws kho mob tuaj yeem tiv tauj Lub Tsev Kho Mob Kho Mob Ntev Ntev ntawm​​  supp1629@dhcs.ca.gov​​ .​​ 

Ob Qhov Chaw Tshiab Tshwj Xeeb Ntxiv-Os rau LTC Nyiaj Rov Qab​​   

  • ACA Employer Mandate Certification Form FAQs (PDF) Hloov tshiab 1/8/16​​ 
 
Cov kab lus hauv qab no tau pib luam tawm nrog daim ntawv xa tawm hnub kawg ntawm Lub Ib Hlis 15, 2016.  Hnub kawg ntawm kev xa daim ntawv thov tau txuas ntxiv mus txog Lub Ob Hlis 29, 2016.​​  
 
Siv tau rau cov hnub ua haujlwm rau lossis tom qab lub Yim Hli 1, 2015, ob qhov txuas ntxiv hauv qab no muaj rau Long Term Care (LTC) cov chaw tshwj xeeb them rov qab rau Cov Neeg Ua Haujlwm Loj (ALE) kom rov qab tau cov nqi vim yog Patient Protection and Affordable Care Act (ACA) Employer Shared Responsibility and Internal Revenue Service (Internal Revenue Service). Hnub kawg rau kev xa daim ntawv thov rau ob qhov ntxiv-ons teev hauv qab no yog Lub Ib Hlis 15, 2016.​​ 

Kev them nyiaj rov qab rau Cov Nqi Ntxiv Ntxiv Vim ACA Employer Shared Responsibility Mandate​​ 

Pib txij xyoo 2015 – 2016 Rate Year, Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom muab cov chaw kho mob tshwj xeeb los ntawm kev them nyiaj rov qab rau Medi-Cal tus nqi them rov qab rau tus nqi ntxiv ntawm kev saib xyuas kev noj qab haus huv nkaus xwb vim yog Tus Neeg Ua Haujlwm Sib Koom Lub Luag Haujlwm uas yuav tsum muaj nyob rau hauv ACA embodied Code 4980. Qhov add-on yuav siv rau cov chaw hauv qab no:​​ 
  • Free-Standing Skilled Nursing Facilities Level B (NF-B)​​ 
  • Free-Sstanding Adult Subacute​​ 
  • Nursing Facilities Level A (NF-A)​​ 
  • Distinct-Part Nursing Facilities Level B (DP/NF-B)​​ 
  • Nyob deb nroog Swing txaj​​ 
  • Distinct-Part Adult Subacute​​ 
  • Distinct-Pab Pediatric Subacute​​ 
  • Dawb-Sawv Pediatric Subacute​​ 
  • Intermediate Care Facilities for the Developmentally Disabled (ICF/DD)​​ 
  • Intermediate Care Facilities for the Developmentally Disabled/Habilitative (ICF/DD-H)​​ 
  • Intermediate Care Facilities for the Developmentally Disabled/Nursing (ICF/DD-N)​​ 
 
Txhawm rau kom tsim nyog tau txais ib qho ntxiv, cov kws kho mob yuav tsum xa Daim Ntawv Pov Thawj Ua pov thawj tias tus tswv hauj lwm yog ALE raws li tau teev tseg los ntawm IRC Tshooj 4980H (thiab nws cov kev tswj hwm thiab kev taw qhia) thiab tau ua rau cov nqi kho mob ntxiv tsuas yog los ntawm ACA Employer Shared Responsibility. Qhov no yog ob xyoos ntxiv rau tus nqi kom txog rau thaum ACA tau txib cov nqi kho mob nyob rau hauv lub tsev kho mob daim ntawv tshaj tawm tus nqi.​​  
  • ACA Employer Shared Responsibility Certification Form Instructions (PDF)​​   
  • ACA Employer Shared Responsibility Certification Form (EXCEL)​​  
 
Cov kws kho mob tuaj yeem xa daim ntawv pov thawj hauv hluav taws xob rau​​  supp1629@dhcs.ca.gov​​  nrog rau cov kab ntawv “ACA Certification Form” nrog rau lawv lub chaw OSHPD tus lej (piv txwv li, “ACA Certification Form 206xxxxxx”). Cov kws kho mob uas tsis muaj peev xwm xa hluav taws xob tuaj yeem xa daim ntawv kos npe ntawm daim ntawv pov thawj rau:​​  

Department of Health Care Services​​ 
Tus Nqi-rau-Service Rate Development Division​​ 
Ntu Kev Kho Mob Ntev Ntev​​ 
Daim ntawv pov thawj ACA​​ 
PO Box 997417, Ste. 71.3052, MS 4600​​ 
Sacramento, CA  95899-7417 ib​​ 

Cov ntaub ntawv no yuav tsum tau txais los ntawm DHCS tsis pub dhau Lub Ib Hlis 15, 2016. Yog xav tau kev pab, cov kws kho mob tuaj yeem tiv tauj Lub Tsev Kho Mob Kho Mob Ntev Ntev ntawm​​  supp1629@dhcs.ca.gov​​ .​​ 

Kev them nyiaj rov qab rau Cov Nqi Ntxiv Ntxiv Vim yog IRS Tus Tswv Cuab Qhia Txoj Cai​​ 

Pib txij xyoo 2015 – 2016 Rate Year, DHCS yuav muab cov chaw kho mob tshwj xeeb them rov qab los ntawm kev ntxiv rau lawv cov Medi-Cal cov nyiaj rov qab rau tus nqi ntxiv​​  ntawm kev ua raws li cov cai tshaj tawm los ntawm IRC Tshooj 6056​​  rau​​  tshaj tawm cov ntaub ntawv qhia txog kev noj qab haus huv rau cov neeg ua haujlwm rau IRS los ntawm kev ua tiav Daim Ntawv 1094-C thiab 1905-C. Qhov add-on yuav siv rau cov chaw hauv qab no:​​ 
  • Intermediate Care Facilities for the Developmentally Disabled/Habilitative (ICF/DD-H)​​ 
  • Intermediate Care Facilities for the Developmentally Disabled/Nursing (ICF/DD-N)​​ 
 
Tsuas yog ICF/DD-H lossis ICF/DD-N cov chaw muab kev pabcuam uas ua tau raws li ALE lub ntsiab lus yuav tsum tau xa daim ntawv pov thawj vim tias qhov chaw ua haujlwm tshaj tawm cov ntawv ntxiv tau suav nrog hauv 2015.​​  -​​  2016 tus nqi them rov qab rau cov chaw hauv qab no:​​ 
  • Free-Standing Skilled Nursing Facilities Level B (NF-B)​​ 
  • Free-Sstanding Adult Subacute​​ 
  • Nursing Facilities Level A (NF-A)​​ 
  • Distinct-Part Nursing Facilities Level B (DP/NF-B)​​ 
  • Nyob deb nroog Swing txaj​​ 
  • Distinct-Part Adult Subacute​​ 
  • Distinct-Pab Pediatric Subacute​​ 
  • Dawb-Sawv Pediatric Subacute​​ 
  • Intermediate Care Facilities for the Developmentally Disabled (ICF/DD)​​ 
 
Yuav kom tsim nyog tau txais ib qho ntxiv, ICF / DD-H lossis ICF / DD-N cov kws kho mob yuav tsum xa daim ntawv​​  Daim ntawv pov thawj​​  txheeb xyuas tias tus tswv ntiav haujlwm yog ALE raws li tau teev tseg los ntawm IRC Tshooj 4980H (thiab nws cov kev coj ua thiab kev taw qhia) thiab tau ua rau cov nqi kho mob ntxiv raws li ACA IRS tus tswv ntiav haujlwm tshaj tawm txoj cai.​​ 
  • ACA Employer Reporting Instruction and Certification Form (WORD)​​ 
 
Cov kws kho mob tuaj yeem xa daim foos no hauv tshuab hluav taws xob rau​​  LTCReimbursement@dhcs.ca.gov​​ , nrog rau ICF/DD-H lossis ICF/DD-N National Provider Identifier (NPI), lub chaw muaj cuaj tus lej ZIP code, thiab "Employee Reporting Cert." nyob rau hauv email subject line. Daim foos tuaj yeem xa los ntawm fax mus rau 1-916-449-5337. Cov ntaub ntawv no yuav tsum tau txais los ntawm DHCS tsis pub dhau Lub Ib Hlis 15, 2016. Yog xav paub ntxiv, cov kws kho mob tuaj yeem xa email ​​  LTCReimbursement@dhcs.ca.gov​​ .​​  
 
 
Hnub hloov tshiab kawg: 3/23/2021 2:19 PM​​