Program Statutes
Statutory authorization for the Department of Health Care Access and Information (HCAI) and its programs is primarily found in Division 107 of the Health and Safety Code, §127000 et seq.
Division 107 is divided into parts that roughly correlate to the Offices within the Department. Some HCAI Offices administer more than one program. (Note that specific program statutes may be located in other areas of the Health and Safety Code, or in other Codes.)
- Office of Health Care Affordability – Part 2, Chapter 2.6, commencing with §127500
- CalRx Program—Part 2, Chapter 10, commencing with §127690
- Office of Health Workforce Development– Part 3, commencing with §127750
- Office of Information Services– Part 5, commencing with §128675
- Office of Health Facility Loan Insurance – Part 6, commencing with §129000
- Office of Statewide Hospital Planning and Development– Part 7, commencing with §129675
- Hospital Fair Billing Program (Hospital Bill Complaint Program) – Part 2, Chapter 2.5, commencing with §127400
California Codes, including the Health and Safety Code, can be accessed through the Official California Legislative Information website. Select “California Law” and then “Health and Safety Code”.
Program Regulations
Most HCAI program regulations are found in Division 7 of Title 22 of the California Code of Regulations (CCR), commencing with §90001.
Division 7 is divided into chapters – HCAI Offices may have regulations in more than one chapter.
- Office of Health Workforce Development (Note that specific program regulations may be found in other parts of the CCR)
- Chapter 6, commencing with §92001
- Chapters 14 – 17, commencing with §97700.1
- Office of Information Services
- Chapter 9, commencing with §96040,
- Chapter 9.5, commencing with §96060,
- Chapter 10, commencing with §97003
- Office of Health Facility Loan Insurance
- Chapter 5, commencing with §91401
- Office of Health Care Affordability
- Chapter 11.5, commencing with §97431
- Hospital Fair Billing Program (Hospital Bill Complaint Program)
- Chapter 9, commencing with §96051
Office of Statewide Hospital Planning and Development adopts building standards that are found in Title 24.
The California Code of Regulations (except for Title 24) can be accessed through the Office of Administrative Law or directly through the California Code of Regulations.
Newly Adopted, Amended, or Repealed Regulations
Posted pursuant to Government Code Section 11343(c).
See the California Code of Regulations website to view a simple text version of the documents in this section.
- Sections 95000, 95001, 95002, 95003, 95004, 95005, 95006, 95007, and 95008 of the California Code of Regulations, Title 22, Division 7, Chapter 8, Hospital Community Reports. Statement of Explanation. Filed with the Secretary of State on November 25, 2024 and effective January 1, 2025.
- Sections 97380, 97382, 97384, 97386, 97388, 97390, 97392, 97394, 97396, 97398, 97400, 97402, 97404, 97406, 97408, 97410, 97412, 97414, 97416 of the California Code of Regulations, Title 22, Division 7, Chapter 11, Health Care Payments Data Program. Adds Article 8, Data Use, Access, and Release. Click to view the Final Statement of Reasons. Filed with the Secretary of State and effective on November 25, 2024.
- Repeal of sections 97700.1 through 97760 of the California Code of Regulations, Title 22, Division 7, Chapter 14, Health Professions Education Foundation. Filed with the Secretary of State and effective October 21, 2024.
- Sections 97431, 97435, 97438, 97439, 97441, and 97442 of the California Code of Regulations, Title 22, Division 7, Chapter 11.5, Article 1, Material Change Transactions and Pre-Transaction Review. Filed with the Secretary of State and effective on August 22, 2024.
- Section 97445 of the California Code of Regulations, Title 22, Division 7, Chapter 11.5, Article 2, Health Care Spending Targets: Definitions, which includes documents incorporated by reference Total Health Care Expenditures (THCE) Data Submission Guide (Version 1.1), dated June 2024 and OHCA Attribution Addendum, dated June 2024. Non-substantive changes were approved by the Office of Administrative Law, filed with the Secretary of State and effective on on July 1, 2024.
- Section 97447 of the California Code of Regulations, Title 22, Division 7, Chapter 11.5, Article 2, Health Care Spending Targets: Statewide Spending Target. Filed as a “File and Print Only” action with the Secretary of State and effective on June 27, 2024.
- Sections 96060, 96061, 96062, 96065, 96070, 96075, 96076, 96077, 96078, 96081, 96082, 96082.5, 96083, 96084, 96085, 96086, and 96087 of the California Code of Regulations, Title 22, Division 7, Chapter 9.5, Articles 1 to 5: Prescription Drug Cost Transparency. Filed with the Secretary of State on December 21, 2023, and effective April 1, 2024.
- Sections 97046, 97046.1, 97046.2, 97046.3, 97046.4, 97046.5, and 97046.6 of California Code of Regulations, Title 22, Division 7, Chapter 10, Article 3.5 Skilled Nursing Facility Consolidated Reporting Requirements. The Final Statement of Reasons may be viewed here. Filed with the Secretary of State and effective on March 6, 2024.
- Sections 97445 and 97449 of the California Code of Regulations, Title 22, Division 7, Chapter 11.5, Article 2: Health Care Spending Targets. Filed with the Secretary of State and effective on March 4, 2024.
- Sections 97431, 97438, and 97442 of the California Code of Regulations, Title 22, Division 7, Chapter 11.5, Article 1: Material Change Transactions and Pre-Transaction Review. Non-substantive changes were filed with the Secretary of State and effective on February 1, 2024.
- Sections 97215, 97219, 97222, 97226, 97231, 97240, 97241, 97246, 97255, 97259, and 97264 of California Code of Regulations, Title 22, Division 7, Chapter 10, Article 8 Patient Data Reporting Requirements. Non-substantive changes were filed with the Secretary of State and effective on December 14, 2023.
- Sections 97019 and 97041 of the California Code of Regulations, Title 22, Division 7, Chapter 10: Related to LTC Facility Financial Reporting – Expanding Managed Care. The regulations were filed with the Secretary of State on October 18, 2023, effective January 1, 2024.
- Sections 97300, 97305, 97310, 97314, 97318, 97330, 97331, 97332, 97334, 97340, 97342, 97344, 97346, 97348, 97349, 97350, 97351, 97352, 97360, 97362, and 97370 of the California Code of Regulations, Title 22, Division 7, Chapter 11, Articles 1 to 7: Health Care Payments Data Program. Filed with the Secretary of State and effective on November 17, 2023.
- Sections 97431, 97435, 97437, 97438, 97439, 97440, 97441, 97442 of the California Code of Regulations, Title 22, Division 7, Chapter 11.5, Article 1: Material Change Transactions and Pre-Transaction Review. Filed with the Secretary of State and effective on December 18, 2023.
- Section 35101 of California Code of Regulations, Title 2 (Administration), Division 8 (Miscellaneous Conflict of Interest Codes), Chapter 14: Office of Statewide Health Planning and Development — Conflict of Interest Code. Filed with Secretary of State April 12, 2023, effective May 12, 2023.
Proposed Regulations
Health Care Payments Data Program
Data Use, Access, and Release
HCAI’s Health Care Payments Data Use, Access, and Release Regulations proposal was published by the Office of Administrative Law (OAL) in the California Regulatory Notice Register on June 2, 2023, which also marks the beginning of the public comment period. The last day to submit comments is July 18, 2023. Additional rulemaking documents are linked below. Please see the Notice of Proposed Rulemaking.
The proposed regulations are expected to be implemented in 2024. Based on comments received during the initial public comment period, HCAI proposes changes to the proposed regulations text. HCAI is making available for public comment the full text of the amended regulations for a period of 45 days ending at 5:00 p.m. Pacific Standard Time on Thursday, February 01, 2024. For more information, visit the Health Care Payments Data (HPD) Program page.
- Updated Initial Statement of Reasons– 12/18/2023
- Revised Text of the Proposed Regulations– 12/18/2023
This 15-day comment period is in response to the feedback received regarding the previous comment period initiated in December. HCAI is providing this 15-day comment period to ensure that members of the public have the opportunity to comment on the revisions to the proposed regulations. HCAI is currently accepting comments from April 4, 2024, to April 19, 2024. Please see the notice for this comment period and the text of the revised proposed regulations directly below.
HCAI has updated the Initial Statement of Reasons to include the changes indicated in the Revised Text of the Proposed Regulations. The Updated Initial Statement of Reasons is available for public review from April 4, 2024, to April 19, 2024. A link to the Updated Initial Statement of Reasons is directly below.
HCAI received the Notice of Disapproval from the Office of Administrative Law on July 10, 2024. Subsequently, the Decision of Disapproval was issued on July 17, 2024. These documents outline the formal rejection of our recent submission. We are currently reviewing the feedback to address the concerns raised.
HCAI’s Health Care Payments Program revised text of the proposed regulations was released for 15-day public comment period on September 06, 2024. The revisions are substantially related to the original proposed text and are being made available for public review and comment for a period of 15-days. All revisions are shown with a single underline and bold for new language and a single strikethrough and bold for deleted language. The last day to submit comments regarding the revised text of the proposed regulations is September 23, 2024. Please see the Notice of Modification to Text of Proposed Regulation. The revised text of the proposed regulations is linked below.
HCAI also added the following documents to the rulemaking file:
- FIPS 140 Validation- The National Institute of Standards and Technology website accessed for print out.
- Contributor Role HPD Work Order Authorization – 06/04/2024
- Duty Statement – Research Data Analyst – 06/2024
- 45 CFR 160.103
- CalHR Payscale – 08/05/2024
Non-Claims Payment Data Collection
The official 45-day public comment period for the Health Care Payments Data (HPD) Non-Claims Payments Data Collection Regulations will began August 2, 2024 and ended on September 17, 2024. This proposed rulemaking is to adopt is to adopt regulations to collect non-claims payments (NCP) data as part of the required HPD data collection efforts under the Health and Safety Code (HSC) section 127673(b).
The proposed regulations have been published by the Office of Administrative Law (OAL) with the Notice of Proposed Rulemaking. Additional documents are linked below. For more information, please visit the Health Care Payments Data Program website.
- Notice of Proposed Rulemaking
- Proposed Regulatory Text
- Initial Statement of Reasons
- Data Submission Guide Amended
- Data Submission Guide 3.0 Final
- NCP Data Layout Version 1.0
HCAI’s Health Care Payments Data Program Non-Claims Payment Data Collection revised text of the proposed regulations is released for a 15-day public comment period on November 6, 2024. The revisions are substantially related to the original proposed text and are being made available for public review and comment for at least 15-days prior to adoption. HCAI also modified and/or added documents to the rulemaking file. All revisions are shown with double underline for new language and double strikethrough for deleted language. The last day to submit comments regarding the revised text of the proposed regulations and documents modified and/or added to the rulemaking file is November 22, 2024.
Please see the Notice of Modification to Regulations. The revised text and documents modified and/or added to the rulemaking file are linked below. For more information, please visit the Health Care Payments Data Program website.
Health Care Affordability
Statewide Spending Target
The Health Care Affordability Board’s Adopted Spending Target (April 2024 meeting) has been codified in regulation as Statewide Spending Target, section 97447 in Health Care Spending Targets, Article 2 of Chapter 11.5 of Division 7 of Title 22, California Code of Regulations, effective June 27, 2024.
Cost and Market Impact Review (CMIR)
The Office of Health Care Affordability (OHCA) adopted emergency regulations to implement the Health Care Market Oversight Program (Cost and Market Impact Review). The Official current regulations in full are here.
On August 22, 2024, the Office of Administrative Law approved and filed with the Secretary of State revisions to the Cost and Market Impact Review (CMIR) regulations (Material Change Transactions and Pre-Transaction Review, Article 1 of Chapter 11.5 of Division 7 of Title 22, California Code of Regulations).
- Final Approved Regulatory Revisions, effective August 22, 2024
- Advance Notice of Proposed Emergency Action (August 5, 2024)
- Finding of Emergency for Proposed Emergency Text
- Proposed Emergency Text (Dated 07/2024)
- Combined Comment Letters Received June 2024 to Draft Revisions
- Draft Revisions (Dated 05/15/2024)
Archive for Prior Regulatory Work on this Topic
Total Health Care Expenditures (THCE) Data Submission
On July 1, 2024, the Office of Administrative Law approved OHCA’s proposed action to amend Article 2, Chapter 11.5, Division 7 of Title 22, California Code of Regulations (CCR) section 97445. The amendments were adopted in compliance with Title 1, Division 1, Chapter 1, Article 2, section 100, of the CCR, and do not materially alter any requirement, right, responsibility, condition, prescription, or other regulatory element of any CCR. This regulatory action became effective on July 1, 2024.
The reasons for the amendments are specified here. The amendments may be viewed using the following links:
Distressed Hospital Financial Monitoring
HCAI’s Distressed Hospital Financial Monitoring regulations proposal was published by the Office of Administrative Law (OAL) in the California Regulatory Notice Register on November 8, 2024, which also marks the beginning of the public comment period. Comments must be submitted by Noon on December 24, 2024. The Notice and other rulemaking documents are linked below.
Hospital Community Benefits Plan Reporting Program
HCAI’s Hospital Community Benefits Plan (CBP) Reporting Program regulation proposal was submitted to the Office of Administrative Law (OAL), and the public comment period began on Friday April 19, 2024. All comments must be received by 5:00 p.m. on June 4, 2024. The proposed regulations are expected to be implemented on October 1, 2024. Please see the Notice of Proposed Rulemaking. Additional rulemaking documents are linked below. For more information, visit the Hospital Community Benefits Plan (CBP) Reporting Program web page.
HCAI’s Hospital Community Benefits Plan Reporting Program revised text of the proposed regulations was released for 15-day public comment period on August 26, 2024. The revisions are substantially related to the original proposed text and are being made available for public review and comment for a period of at least 15 days prior to adoption. All revisions are shown with a double underline for new language and a double strikethrough for deleted language. The last day to submit comments regarding the revised text of the proposed regulations is September 11, 2024. Please see the Notice of Modification to Text of Proposed Regulation. The revised text of the proposed regulations is linked below.
Hospital Equity Measures Reporting Program
HCAI’s Hospital Equity Measures Reporting Program regulation proposal was submitted to the Office of Administrative Law (OAL), and the public comment period began on Friday June 28, 2024. All comments must be received by 5:00 p.m. on August 13, 2024. The proposed regulations are expected to be implemented on January 1, 2025. Please see the Notice of Proposed Rulemaking. Additional rulemaking documents are linked below. For more information, visit the Hospital Equity Measures Reporting Program web page.
- Initial Statement of Reasons
- Text of the Proposed Regulations
- Measures Submission Guide
- The California Health and Human Services Agency’s ‘Data De-Identification Guidelines (DDG),’ version 1.0, dated September 23, 2016
- Department’s Format and File Specification for Submission of the Hospital Equity Report, Version 1.0, dated April 15, 2024. (PDF)(Excel)
HCAI is restarting the 15-day notice period for the Hospital Equity Measures Reporting Program’s revised text of the proposed regulations due to a minor clerical error in the original announcement.
HCAI’s Hospital Equity Measures Reporting Program revised text of the proposed regulations was released for 15-day public comment period on October 14, 2024. The revisions are substantially related to the original proposed text and are being made available for public review and comment for a period of at least 15 days prior to adoption. All revisions are shown with a double underline for new language and a double strikethrough for deleted language. The last day to submit comments regarding the revised text of the proposed regulations is October 29, 2024. Please see the Notice of Modification to Text of Proposed Regulation and addition of documents modified and/or added to the rulemaking file. The revised text of the proposed regulations is linked below.
- Revised Text of the Proposed Regulations
- Hospital Equity Report: Measures Submission Guide Version 1.1 September 9, 2024
- Format and File Specification for Submission of the Hospital Equity Report Version 1.1 September 9, 2024
- Methodology for Calculating HCAI All-Cause Unplanned, 30-Day Hospital Readmission Rates
Conflict of Interest
The Political Reform Act of 1974 requires certain officials and employees who serve in positions designated in an agency’s conflict of interest code to publicly disclose specified personal economic interests. Such economic interests are disclosed on the Form 700, Statement of Economic Interests. Pursuant to Government Code section 81008, Form 700 Statement of Economic Interests are public records and will be made available for public inspection.
The HCAI Conflict of Interest Code identifies the positions that are subject to the Form 700 Statement of Economic Interests filing requirements. It also specifies the types of economic interests required to be disclosed. For any questions contact the HCAI Filing Officer.