23-1345 Required: Ensure Subacute Care Facilities Are Contracted With the DHCS Subacute Contracting Unit

Date: 11/16/23

Refer to attached Subacute Care Contracting Fact Sheet

Effective January 1, 2024, Medi-Cal managed care plans in all counties must ensure that members in need of adult or pediatric subacute care services are placed in a health care facility that is under contract for subacute care with the California Department of Health Care Services (DHCS) Subacute Contracting Unit (SCU) or is actively in the process of applying for a contract with SCU. In order to receive Medi-Cal subacute care reimbursement, a provider must be contracted with DHCS as per CCR, title 22, section 51215.6 (a) which states “Adult subacute services and pediatric subacute services shall be provided by a licensed general acute care hospital with distinct-part skilled nursing beds or a freestanding certified nursing facility that enters into a contract with the Department.” This requirement ensures that facilities receiving Medi-Cal subacute care reimbursement meet certain standards and that Members residing in these facilities do not experience disruptions in access to care.

In order for facilities to receive Medi-Cal reimbursement, they must have a Subacute Care Program contract with DHCS SCU. Facilities must submit an application to SCU by December 15, 2023. The list of the currently contracted providers is available on the Medi-Cal Subacute website.

If your facility is already contracted with DHCS SCU, you do not need to do anything at this time.

If your facility is not contracted with DHCS’ SCU, please contact by email as soon as possible to request an application. For more information, please refer to the Medi-Cal Subacute Care Contracting: Application Information for Facilities Fact Sheet. Additional information can be found at Subacute Care Facility Carve-In.  

 

This information applies to Participating Physician Groups (PPGs), Hospitals, and Nursing Facilities/Skilled Nursing Facilities.