In April of 2014, the Protecting Access to Medicare Act was signed into law. Part of the law stated that the outpatient and physician reimbursement for certain diagnostic CT scans will be reduced by 5 percent in 2016 and a further 15 percent in 2017 if a CT system is not compliant with XR-29 guidelines.... Read More >>

The Health Resources and Services Administration's (HRSA) 340B hospital recertification process for 2016 continues through Sept. 7. All 340B hospitals must recertify with HRSA annually to ensure they continue to meet the 340B hospital eligibility requirements. ... Read More >>

With the start of the new state fiscal year there have been some changes to the hospital safety net program. Working with WSHA, the Health Care Authority has reset the assessment amounts for the new fiscal year. ... Read More >>

The Bree Collaborative, a Governor-appointed group of public and private partners working to improve health care quality, outcomes and affordability, is considering prior authorization as one of its focal points for the upcoming year. ... Read More >>

WSHA is working to address the difficulty many hospitals face in finding post-hospital placement for patients who have completed their acute care hospital stay. ... Read More >>

Legislators and the Washington State Insurance Commissioner, Mike Kriedler, are planning legislation for the 2017 legislative session to address the issue of balance billing of patients for services provided outside of the health plan’s network. Legislation was considered last year but did not end up passing. Now the issue is back. ... Read More >>

Effective July 1, 2016, the majority of Washington hospitals paid under prospective payment system became eligible for a one-percent quality incentive increase to their Medicaid inpatient payment rates (for both inpatient APRDRG and per diem rates). This is a significant increase in the number of hospitals qualifying. ... Read More >>

WSHA hosted two webcasts on July 26 detailing how the Medicare Access and CHIP Reauthorization Act (MACRA) passed by Congress in 2015 fundamentally changes how physicians are paid. WSHA hosted two separate webcasts, one tailored to critical access hospitals and the second to larger hospitals and health systems.... Read More >>

The Office of the Insurance Commissioner (OIC) recently released a stakeholder draft of rules pertaining to prior authorizations, the first step in the rule making process. WSHA, WSMA, and many of our members have been asking the OIC to more carefully regulate this process in order to reduce administrative overhead for providers.... Read More >>

As part of its inpatient final rule released yesterday, the Centers for Medicare and Medicaid Services (CMS) is delaying the implementation of the Medicare Outpatient Observation Notification requirements originally scheduled to go into effect August 6, 2016... Read More >>