Directed Payments DPH Enhanced Payment Program
Beginning with the July 1, 2017, rating period, the Department will direct MCPs to reimburse California’s 21 DPHs for network contracted services delivered by DPH systems, enhanced by either a uniform percentage (“CA DPH Capitated Uniform”) or dollar increment based (“DPH FFS Uniform”) on actual utilization of network contracted services. The state will evaluate the extent to which enhanced payments are achieving the goals identified. These may only apply to certain managed care categories of aid. The payments will be enhanced by either a uniform percentage or dollar increment. The total funding available for the enhanced network contracted payments will be limited to a predetermined amount (pool).
Designated Public Hospital Capitated Payments
Designated Public Hospital FFS Payments