HCA Implements Potentially Preventable Readmission (PPR) Adjustments

The purpose of this bulletin is to inform Prospective Payment System (PPS) hospitals of changes to their Medicaid inpatient hospital payment rates effective January 1, 2016 due to changes to the Health Care Authority’s policy on paying for readmissions. HCA is replacing its existing policy of reviewing and denying individual readmission claims with a policy that uses a software program to compare each hospital’s rate of potentially preventable readmissions (PPR) rate with an expected rate based on the state’s general experience and the hospital’s mix of cases. Hospitals with higher than expected potentially preventable readmissions are subject to a penalty reduction applied to their inpatient payment rate.... Read More >>

Health Care Authority to make prospective inpatient payment correction

The purpose of this bulletin is to inform Prospective Payment System (PPS) hospitals of the Health Care Authority’s response to requests filed by WSHA hospitals appealing the significant reduction in PPS Medicaid inpatient and outpatient rates effective November 1, 2015. ... Read More >>

State Seeking Global Waiver Project Proposals

The purpose of this bulletin is to make you aware that the state is soliciting local and statewide projects for exploration and selection in the state’s global waiver negotiations with the Centers for Medicare & Medicaid Services for Medicaid. Project proposals are due January 15, 2016 to the state Health Care Authority (HCA).... Read More >>

Standardized Financial Assistance Application and Communication Plan

This bulletin provides information on two financial assistance documents that WSHA will recommend every hospital adopt. WSHA intends to recommend that all hospitals adopt the standard financial assistance application and communication plan once these documents are finalized and approved by the WSHA Board. These documents focus on the patient-facing portions of the financial assistance process and do not dictate the levels of financial assistance offered at individual hospitals.... Read More >>

Sample Language for Appeal of Medicaid PPS Rates Effective November 1

The purpose of this bulletin is to provide Prospective Payment System (PPS) hospitals with information should they wish to appeal changes to their Medicaid hospital payment rates effective November 1. WSHA recommends they file a rate appeal with the Health Care Authority (HCA) within 60 days of the date of their rate notice to protect their right to a rate correction if it is determined the new rates are in error.... Read More >>

Reduction in Medicaid PPS Rates Effective November 1

The purpose of this bulletin is to inform Prospective Payment System (PPS) hospitals of significant changes to their Medicaid hospital payment rates effective November 1. WSHA recommends they file a rate appeal with the Health Care Authority (HCA).... Read More >>

New Opportunities For State Student Loan Repayment Funding

The purpose of this bulletin is to inform you of an opportunity for mental health, pharmacists, and primary care providers to be eligible for student loan repayment funds through the newly re-instituted state loan repayment program, the Health Professional Loan Repayment Program (HPLRP). This new program is offered in addition to the continuing federal National Health Service Corps, and the Federal-State Loan Repayment Program (FSLRP). WSHA supported the funding for state-based loan repayment funds in the 2015-2017 legislative session. We were pleased the program received $8.2 million for distribution over these two years.... Read More >>

Implementing Senate Bill 5593 – Delivery and Payment for Health Care Services by Hospitals for Inmates and Persons Detained by Law Enforcement

This bulletin is intended to inform you of important changes in Washington state law as a result of enactment of Senate Bill 5593. The bill addresses two issues related to care for people in law enforcement custody: guarding and payment.... Read More >>

State Law Change Strengthens Consumer Data Breach Notification Requirement, Exemption for Hospitals Complying with Federal HITECH Law

The purpose of this bulletin is to provide an overview of recent changes to Washington State’s data breach notification law relevant to Washington State hospitals and health systems. The Washington State Hospital Association (WSHA) worked closely with the state Attorney General’s Office to develop important exceptions in the new law for entities covered under federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) when they are acting in compliance with the federal Health Information Technology for Economic and Clinical Health Act (HITECH).... Read More >>

New Federal Law Requiring Notification to Medicare Patients Placed in Observation Status

The purpose of the bulletin is to inform hospitals about the new federal law Public Law 114-42, The NOTICE Act (H.R.876), that requires hospitals to provide oral and written notification to Medicare patients placed into observation status for longer than 24 hours. Also to let hospitals know of WSHA's plans to provide opportunities for WSHA-member hospitals to share and communicate best practices and prepare for the new law.... Read More >>

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