State’s Proposal to Waive Medicaid Requirements in Order to Accelerate Transformation

This bulletin provides information on the state’s plan to apply for a waiver of federal Medicaid requirements in order to accelerate its work on health care system transformation. ... Read More >>

SBC: New Emergency Rule Effective April 21 for Patients with Medical Conditions

The purpose of this bulletin is to: Inform hospitals of the new emergency rule filed on April 21 by the Washington State Department of Social and Health Services (DSHS) impacting single bed certification for patients with medical conditions and provide updated designated mental health professional protocols to hospitals. Pages 23 and 24 contain information about single bed certification.... Read More >>

Update to Safety Net Assessment Program Accounting Recommendations

This memorandum is intended to update guidance to hospitals concerning financial reporting of hospital safety net assessment program-related expenses and payments. This update provides information on a recent Center for Medicare & Medicaid Service’s (CMS’s) approval of the Medicaid managed care contracts for the period ending December 31, 2013. ... Read More >>

Washington State’s Healthier Washington

This bulletin provides initial information on the state’s new plan to transform the delivery of care in Washington State, “Healthier Washington.” It also discusses WSHA’s actions to shape the decisions and how hospitals should engage in this multi-year process. ... Read More >>

WSHA and AWPHD Report on Lobbying Expenses for Medicare Cost Reports

The purpose of this Bulletin is to inform WSHA and AWPHD members of the proportion of membership dues used for lobbying purposes.... Read More >>

Update on Outreach and Enrollment

This year’s open enrollment period will close on February 15, 2015. While Medicaid-eligible patients will still be able to use www.wahealthplanfinder.org to enroll in AppleHealth, most of the people enrolling in commercial insurance will lose their opportunity until the next open enrollment period.... Read More >>

DOH Begins Review of Certificate of Need Tertiary Health Services

The Washington State Department of Health (the Department) Certificate of Need program has announced it is moving forward with review of tertiary health services that are subject to Certificate of Need. The Department will determine whether any changes are necessary to the tertiary health services list. Changes could include additions to or deletions from the list. We want to make sure you are aware this process has started so you can participate as appropriate in the public comment period, the first phase of which is January 1, 2015 to February 28, 2015.... Read More >>

SBC: New Emergency Rule Effective December 26 and Practical Guidance For Hospitals

The purpose of this bulletin is to: 1) Inform hospitals that the Washington State Supreme Court’s decision, In re the Detention of DW; 2) Inform hospitals about the Washington State Department of Social and Health Services’ (DSHS) new emergency rule for Single Bed Certification; 3) Provide information to help hospitals manage in circumstances where a designated mental health professional finds a patient meets detention criteria under the Involuntary Treatment Act, but declines to detain a patient due to no available appropriate inpatient psychiatric bed. ... Read More >>

Medicaid Outpatient PPS Pricing Issues

This bulletin provides important information on problems hospitals are experiencing with the Health Care Authority’s (HCA) programming of payments using Enhanced Ambulatory Payment Groups (EAPGs).The issues, stemming from pricing in HCA’s ProviderOne system, are causing significant numbers of outpatient hospital Medicaid claims to be underpaid or not paid at all. ... Read More >>

HCA to Implement Hospital Presumptive Eligibility in January

The purpose of this bulletin is to notify you that the Washington State Health Care Authority (HCA) is now implementing “Hospital Presumptive Eligibility” (HPE) for Apple Health Enrollment. The HCA will offer trainings in January 2015 for any hospital that registers for the training by December 19, 2014. HPE allows a hospital to enroll someone in Medicaid for up to 60 days with minimal information from the client. For example, if a client does not know their tax filing status, hospitals can enroll via HPE. Or if there is a glitch preventing enrollment using the Washington Healthplanfinder website, a hospital can enroll someone immediately via Hospital Presumptive Eligibility. ... Read More >>

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