A resource for CAPH members to access past editions of our newsletter featuring policy updates, program highlights, and tools to support California’s public health care systems. Newsletters are organized from most recent to oldest.
To be added to the distribution list, members should reach out to Claudia Coons.
Covers the nation’s longest-ever federal government shutdown, its growing local impacts, and community-driven support efforts across California. Highlights passage of Proposition 50 and Santa Clara County’s Measure A as key policy developments, ongoing CAPH advocacy to delay DSH cuts and restore Medicare telehealth flexibilities, California’s application for the $500M Rural Health Transformation Fund, and HRSA’s 340B rebate pilot approvals.
Details the fourth week of the federal shutdown and its effects on CalFresh and CalWORKs, alongside California’s emergency food assistance response. Reviews upcoming ballot measures—Proposition 50 on redistricting and Santa Clara County’s Measure A sales tax—and CAPH advocacy priorities on DSH and telehealth. Includes CMS telehealth guidance, Medi-Medi enrollment expansion, and upcoming DHCS and Health4All webinars.
Focuses on the second week of the federal shutdown and CAPH advocacy to delay DSH cuts and extend Medicare telehealth flexibilities. Summarizes end-of-session state legislation including SB 81 on patient immigration protections, CAPH’s opposition to SB 596 on staffing ratios, and updates from DHCS on data sharing, Transitional Rent payments, reinstated asset limits, and the Medi-Cal doula directory.
Addresses potential federal government shutdown and October 1 deadline for Medicaid DSH cuts ($856M annual loss) and Medicare telehealth flexibilities expiration, Trump’s H-1B visa restrictions imposing $100K fees affecting healthcare workforce recruitment, and California vaccine access protections webinar.
Covers end of legislative session with state budget advocacy successes (reduced UIS premiums to $30, delayed PPS elimination), continued opposition to SB 596 nurse staffing requirements, and federal focus on preventing DSH cuts and extending Medicare telehealth flexibilities expiring September 30.
Focuses on urgent advocacy to prevent October 1 Medicaid DSH cuts ($856M annual California impact), state legislative session ending September 13 with suspense file votes on key bills, and Office of Health Care Affordability enforcement discussions accounting for H.R. 1 impacts.
Covers federal reconciliation bill’s nearly $1 trillion Medicaid cuts and multi-front advocacy strategy, state legislature’s return with appropriations deadlines, AB 1204 equity reporting portal opening September 30, and 340B recertification requirements through September 8.
Addresses immigration enforcement fears causing patient no-shows and care avoidance, state legislative recess advocacy opportunities, and DHCS revision of MCO tax spending amid H.R. 1 federal restrictions that could end the tax early.
Discusses HHS expansion of “federal public benefits” definition affecting FQHCs serving immigrants, anticipated September Medicaid DSH cuts ($800M+ impact), and state legislature completing policy hearings before summer recess.
Covers passage of 2025-2026 state budget eliminating PPS payments for UIS FQHCs and imposing premiums, California’s multi-state lawsuit blocking Medicaid data sharing with DHS, and Senate reconciliation bill with state directed payment caps.
Reports on Senate Finance Committee’s reconciliation bill proposing deeper Medicaid cuts including state directed payment annual reductions, California Legislature’s budget modifications delaying some UIS cuts, and CMS announcing increased oversight of Medicaid immigrant funding.
Covers California’s $12 billion deficit with proposed Medi-Cal cuts targeting UIS population (enrollment freeze, PPS elimination, $100 premiums), ongoing state budget negotiations ahead of June 15 deadline, and updates on priority legislation affecting public health care systems.
Covers House passage of the “One Big Beautiful Bill” with devastating Medicaid cuts and California’s May Revise addressing a $12 billion deficit. Includes legislative appropriations updates, federal budget reconciliation details, and new executive orders targeting drug costs.
Highlights innovation examples from public health care systems while warning about $880 billion in federal spending cuts targeting Medicaid. Includes MCO tax stakeholder updates, OHCA high-cost hospital target decisions, and federal restrictions on gender-affirming care.
Focuses on continued Medicaid advocacy during congressional spring recess and messaging strategies for protecting Medicaid from federal cuts. Covers Proposition 35 advisory committee launch, new psychiatric emergency care requirements, and federal 340B drug pricing executive order.
Recaps successful State Lobby Day with 20 participants conducting 50+ legislative meetings on Medicaid protection and OHCA concerns. Includes updates on hospital regulatory guidance, emergency medical services regulations, and Proposition 35 implementation.
Covers advocacy efforts following continuing resolution passage and showcases Arrowhead Regional Medical Center’s “I Matter” advocacy video. Provides updates on state lobby day, federal continuing resolution impacts, and court decisions on gender-affirming care.
Features a patient success story from Alameda Health System to highlight the importance of public health care systems. Includes state budget hearing updates, OHCA high-cost hospital proposals, and various new laws and regulatory guidance.
Discusses strategies for managing constant policy changes and provides updates on state legislation and CalHHS Secretary confirmation. Covers OHCA developments, federal lobby planning, and Trump administration executive order on gender affirming care for minors.
Focuses on continued wildfire response and federal administration proposals affecting public health care systems. Includes updates on Medi-Cal support for wildfire victims, immigration policy changes, and various state program developments.
Addresses LA wildfire impacts on public health care systems and announces new health committee chairs for the 2025-2026 legislative session. Features California’s approval of the BH-CONNECT behavioral health waiver and CMS approval of MCO tax waiver amendment securing $7.2 billion.
Covers CAPH Annual Conference recap and federal lobby day meetings with California senators and representatives about DSH payments, telehealth waivers, and Medicaid concerns. Also includes state updates on weapons detection requirements, CalAIM funding, and federal telehealth prescribing waiver extensions.
Thanksgiving message expressing gratitude for public health care workers’ dedication throughout 2024’s challenges and triumphs. Covers California state election results with ~40 new legislators, OHCA Board developments including new leadership, and various CalAIM program updates.
Addresses post-presidential election uncertainty and planning for multiple scenarios while celebrating Proposition 35’s passage to make MCO tax permanent. Includes updates on Data Exchange Framework roadmap, Hospital Fair Pricing Act changes, and federal Medicare coverage modifications for FQHCs.
Examines election uncertainties and their potential impact on public health care systems at federal and state levels. Features OHCA Board discussions on sector-specific spending targets and hospital-specific cost controls, plus resources for financial assistance policy updates.
Discusses insights from America’s Essential Hospital’s Medicaid Summit, focusing on State Directed Payments opportunities, vulnerabilities with self-financed supplementals, and potential restrictive Medicaid policies under a Trump administration. Covers legislative updates, federal TEAM model implementation, and enhanced care management guidance.
GPP PY10 Health Equity Reporting Manual User Agreement AMA PQA CMS v20250501
End User Agreement
Please review this agreement and click “Accept” at the end of this agreement if you agree to the terms of this agreement. If you do not agree, please click “Cancel”; in this case, you will not be able to access the Reporting Manual.
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (“CPT®”)
End User Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2023 American Medical Association (AMA). All Rights Reserved. CPT is a trademark of the AMA.
You, your employees and agents are authorized to use CPT only as contained in the QIP PY7 Reporting Manual solely for your own personal use and only for participating in state governmental healthcare related programs supported by and/or administered by California Health Care Safety Net Institute (SNI). You acknowledge that the “AMA” holds all copyright, trademark and other rights in CPT.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza, 330 Wabash Ave, Suite 39300, Chicago, IL 60611-5885. Applications are available at the AMA Web site (http://www.ama-assn.org/go/cpt.).
U.S. GOVERNMENT RIGHTS
This product includes CPT which is commercial technical data, which was developed exclusively at private expense by the AMA, 330 Wabash Avenue, Chicago, IL 60611. The AMA does not agree to license CPT to the Federal Government based on the license in FAR 52.227-14 (Data Rights - General) and DFARS 252.227-7015 (Technical Data - Commercial Items) or any other license provision. The AMA reserves all rights to approve any license with any Federal agency.
DISCLAIMER OF WARRANTIES AND LIABILITIES
CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this product is with SNI, and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.
This agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this agreement.
CMS MEDICAID ADULT AND CHILD CORE SET
License Agreements
Please review the licensing information below and indicate your agreement and acceptance.
LICENSE FOR USE OF PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (CPT)
End User Point and Click Agreement:
CPT codes, descriptions and other data only are copyright 2021 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.
You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials of Centers for Medicare and Medicaid Services (CMS) internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid or other programs administered by CMS. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza, 330 Wabash Ave., Suite 39300, Chicago, IL 60654. Applications are available at the AMA website, http://www.ama-assn.org/go/cpt.
Applicable FARS\DFARS Restrictions Apply to Government Use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the AMA, AMA Plaza, 330 Wabash Ave., Suite 39300, Chicago, IL, 60611- 5885. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Defense Department procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non- Department of Defense Federal procurements.
AMA DISCLAIMER OF WARRANTIES AND LIABILITIES
CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.
CMS DISCLAIMER
The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
LICENSE FOR NATIONAL UNIFORM BILLING COMMITTEE (NUBC)
These materials contain the NUBC Official UB-04 Specifications Manual and data codes (UB-04 Data), which are copyrighted 2023 by the American Hospital Association (AHA), Chicago, IL. Reproduced with permission. No portion of the AHA copyrighted materials may be copied without express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816.
Making copies or utilizing the content of the UB-04 Manual, including codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of the UB-04 Manual or any portion thereof, including the codes and/or descriptions is only authorized with an express license from the AHA.
The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in the agreement. By clicking below on the button labeled “Accept” you hereby acknowledge that you have read, understood, and agreed to all terms and conditions set forth in this agreement.
If you do not agree with all terms and conditions set forth herein, click below on the button labeled “Do Not Accept” and exit from this computer screen.
If you are acting on behalf on an organization, you represent that you are authorized to act on behalf of such an organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. As used herein, “you” and “your” refer to you and any organization on behalf of which you are acting.
1. Subject to the terms and conditions contained in this agreement, you, your employees, and agents are authorized to use UB-04 Data only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of UB-04 Data is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the AHA holds all copyright, trademark, and other rights in UB-04 Data. You shall not remove, alter, or obscure any AHA copyright notices or other proprietary rights notices included in the materials.
2. Any use not authorized herein is prohibited, including, by way of illustration and not by way of limitation, making copies of UB-04 Data for resale and/or license, transferring copies of UB-04 Data to any party not bound by this agreement, creating any modified or derivative work of UB-04 Data, or making any commercial use of UB-04 Data. License to use UB-04 Data for any use not authorized herein must be obtained through the AHA, 155 N. Wacker Drive, Suite 400, Chicago, IL, 60606. Applications are available at the NUBC website, http://www.nubc.org/.
3. The UB-04 Data included in this product is commercial technical data and/or computer databases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the AHA, 155 N. Wacker Drive, Suite 400, Chicago, IL, 60606. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (December 2007) and FAR 52.227-19 (December 2007), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
AHA DISCLAIMER
The AHA hasn’t reviewed and isn’t responsible for the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessary represent the views of the AHA. CMS and its products and services aren’t endorsed by the AHA or any of its affiliates.
AHA DISCLAIMER OF WARRANTIES AND LIABILITIES
UB-04 Data is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The sole responsibility for the software, including any UB-04 Data and other content contained therein, is with the Medicare/Medicaid Contractor or the CMS; and no endorsement by the AHA is intended or implied. The AHA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This agreement will terminate upon notice to you if you violate the terms of this agreement. The AHA is a third-party beneficiary to this agreement.
CMS DISCLAIMER
The scope of this license is determined by the AHA, the copyright holder. Any questions pertaining to the license or use of the UB-04 Data should be addressed to the AHA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USE OF THE UB-04 DATA. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMMISSIONS OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled “I agree”.
QIP PY8 Reporting Manual User Agreement AMA PQA CMS v20241211
End User Agreement
Please review this agreement and click “Accept” at the end of this agreement if you agree to the terms of this agreement. If you do not agree, please click “Cancel”; in this case, you will not be able to access the Reporting Manual.
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (“CPT®”)
End User Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2022 American Medical Association (AMA). All Rights Reserved. CPT is a trademark of the AMA.
You, your employees and agents are authorized to use CPT only as contained in the QIP PY8 Reporting Manual solely for your own personal use and only for participating in state governmental healthcare related programs supported by and/or administered by California Health Care Safety Net Institute (SNI). You acknowledge that the “AMA” holds all copyright, trademark and other rights in CPT.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza, 330 Wabash Ave, Suite 39300, Chicago, IL 60611-5885. Applications are available at the AMA Web site (http://www.ama-assn.org/go/cpt.).
U.S. GOVERNMENT RIGHTS
This product includes CPT which is commercial technical data, which was developed exclusively at private expense by the AMA, 330 Wabash Avenue, Chicago, IL 60611. The AMA does not agree to license CPT to the Federal Government based on the license in FAR 52.227-14 (Data Rights - General) and DFARS 252.227-7015 (Technical Data - Commercial Items) or any other license provision. The AMA reserves all rights to approve any license with any Federal agency.
DISCLAIMER OF WARRANTIES AND LIABILITIES
CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this product is with SNI, and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.
This agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this agreement.
PHARMACY QUALITY ALLIANCE COPYRIGHT STATEMENT
By agreeing to this policy, user accepts the following limitations of the QIP’s use of the Pharmacy Quality Alliance (PQA) Opioid measures and code sets: To accurately calculate the measure rates, the PQA value sets are required. User acknowledges that the PQA measures and value sets will only be used for the sole purpose of evaluating and improving opioid use for populations served by Public Health Care Systems (PHS) and District and Municipal Hospitals (DMPH) and will not be used for other purposes. Except for the purpose indicated above, the PQA measures and value sets will not be used for any other commercial product, service or value-added benefit. User also acknowledges that the information and PQA value sets will not be forwarded or provided to anyone outside of SNI, the California Department of Health Care Services (DHCS), the PHS or the DMPH.
CMS MEDICAID ADULT AND CHILD CORE SET
License Agreements
Please review the licensing information below and indicate your agreement and acceptance.
LICENSE FOR USE OF PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (CPT)
End User Point and Click Agreement:
CPT codes, descriptions and other data only are copyright 2021 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.
You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials of Centers for Medicare and Medicaid Services (CMS) internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid or other programs administered by CMS. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza, 330 Wabash Ave., Suite 39300, Chicago, IL 60654. Applications are available at the AMA website, http://www.ama-assn.org/go/cpt.
Applicable FARS\DFARS Restrictions Apply to Government Use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the AMA, AMA Plaza, 330 Wabash Ave., Suite 39300, Chicago, IL, 60611- 5885. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Defense Department procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non- Department of Defense Federal procurements.
AMA DISCLAIMER OF WARRANTIES AND LIABILITIES
CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.
CMS DISCLAIMER
The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
LICENSE FOR NATIONAL UNIFORM BILLING COMMITTEE (NUBC)
These materials contain the NUBC Official UB-04 Specifications Manual and data codes (UB-04 Data), which are copyrighted 2022 by the American Hospital Association (AHA), Chicago, IL. Reproduced with permission. No portion of the AHA copyrighted materials may be copied without express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816.
Making copies or utilizing the content of the UB-04 Manual, including codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of the UB-04 Manual or any portion thereof, including the codes and/or descriptions is only authorized with an express license from the AHA.
The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in the agreement. By clicking below on the button labeled “Accept” you hereby acknowledge that you have read, understood, and agreed to all terms and conditions set forth in this agreement.
If you do not agree with all terms and conditions set forth herein, click below on the button labeled “Do Not Accept” and exit from this computer screen.
If you are acting on behalf on an organization, you represent that you are authorized to act on behalf of such an organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. As used herein, “you” and “your” refer to you and any organization on behalf of which you are acting.
1. Subject to the terms and conditions contained in this agreement, you, your employees, and agents are authorized to use UB-04 Data only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of UB-04 Data is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the AHA holds all copyright, trademark, and other rights in UB-04 Data. You shall not remove, alter, or obscure any AHA copyright notices or other proprietary rights notices included in the materials.
2. Any use not authorized herein is prohibited, including, by way of illustration and not by way of limitation, making copies of UB-04 Data for resale and/or license, transferring copies of UB-04 Data to any party not bound by this agreement, creating any modified or derivative work of UB-04 Data, or making any commercial use of UB-04 Data. License to use UB-04 Data for any use not authorized herein must be obtained through the AHA, 155 N. Wacker Drive, Suite 400, Chicago, IL, 60606. Applications are available at the NUBC website, http://www.nubc.org/.
3. The UB-04 Data included in this product is commercial technical data and/or computer databases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the AHA, 155 N. Wacker Drive, Suite 400, Chicago, IL, 60606. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (December 2007) and FAR 52.227-19 (December 2007), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
AHA DISCLAIMER
The AHA hasn’t reviewed and isn’t responsible for the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessary represent the views of the AHA. CMS and its products and services aren’t endorsed by the AHA or any of its affiliates.
AHA DISCLAIMER OF WARRANTIES AND LIABILITIES
UB-04 Data is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The sole responsibility for the software, including any UB-04 Data and other content contained therein, is with the Medicare/Medicaid Contractor or the CMS; and no endorsement by the AHA is intended or implied. The AHA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This agreement will terminate upon notice to you if you violate the terms of this agreement. The AHA is a third-party beneficiary to this agreement.
CMS DISCLAIMER
The scope of this license is determined by the AHA, the copyright holder. Any questions pertaining to the license or use of the UB-04 Data should be addressed to the AHA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USE OF THE UB-04 DATA. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMMISSIONS OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled “I agree”.
