For a number of California’s hospitals the Medi-Cal disproportionate share payment program has played a significant role in providing necessary funding to allow them to maintain their financial viability. For these hospitals it has become a yearly exercise to analyze and correct their data to ensure continued eligibility at existing or improved levels of payment. To accomplish this objective the services that are provided include:

  • Review of hospital data specifically utilized by the Medi-Cal DSH program that is being reported to the Office of Statewide Health Planning and Development (OSHPD). Analyze how the data is captured and mapped through the hospitals accounting system to ensure that the reporting is accurate and grouped correctly.
  • A review of the billing data that is sent to the Medi‐Cal program. This requires a review of the Medi-Cal paid claims data and its linkage with the reporting of the data on the OSHPD report. In addition, this data analysis is used to determine the payment levels that will be received by each hospital.
  • Understanding alternative interpretations of how data must be reported to OSHPD. Over a number of years our firm has worked directly with OSHPD to address numerous accounting interpretations that directly link to data used by the Medi-Cal DSH program to ensure hospital data corrections meet OSHPD standards. These interpretations are then utilized as part of the review process.