Medicare Provider Re-validation: Update Your Enrollment to Avoid Payment Delays!

The Centers for Medicare & Medicaid Services has begun a provider re-validation process to identify and update changes that have occurred since the provider’s original enrollment. This process includes both institutional providers, such as hospitals, and individual providers.... Read More >>

SUNRx Offers 340b Solutions!

Washington Hospital Services Industry Partner SUNRx, an Industry leader in the 340b prescription program, now offers variable pricing structures, which allows you to optimize your 340b program. The new pricing models include switch fee model pricing, which allows easier access to their solutions, which already boast the lowest pricing and the most compliant 340b program nationwide.... Read More >>

WSHA Comments to CMS Regarding Value-based Physician Payment

WSHA recently submitted comments on the Center for Medicare and Medicaid Service’s proposed rule regarding physician payment under the Medicare Access and CHIP Reauthorization Act (MACRA). The act replaces the current sustainable growth rates formula governing physician payment with a new structure that will adjust physician payments based on attainment of quality measures. ... Read More >>

WSHA Comments to OIC Regarding Prior Authorizations

On June 28, WSHA testified at a meeting convened by the Office of the Insurance Commissioner (OIC) regarding potential rulemaking on health plan prior authorizations. In its comments WSHA requested that OIC require plans to make available to providers criteria used to determine medical necessity for prior authorizations and better integrate authorizations provided through plan-contracted benefit managers and other entities.... Read More >>

HCA to Reprocess Outpatient Hospital Claims

The Health Care Authority (HCA) has advised WSHA that a number of outpatient hospital claims paid through the ProviderOne system over the last six weeks were paid at incorrect grouper weights rates and will be reprocessed though a mass adjustment process. The payment error was made as HCA began to prepare for a July 1st update to its outpatient Enhanced Ambulatory Payment Group (EAPG) payment system. ... Read More >>

AHRQ report summarizes research on telehealth’s clinical benefits

elehealth interventions produce positive outcomes when used for remote monitoring, communication and counseling for patients with chronic conditions and for psychiatric services provided as part of behavioral health, according to a new report by the Agency for Healthcare Research and Quality.... Read More >>

AHA analysis finds bias in star rating methodology

A new analysis commissioned by the American Hospital Association (AHA) examines the fundamental design flaws of star ratings, and whether it is an accurate tool to compare hospital performance. The Centers for Medicare & Medicaid Services (CMS) star ratings system was designed to help consumers, their families and caregivers compare facilities.... Read More >>

WSHA and WSMA launch opioid task force

SHA and the Washington State Medical Association (WSMA) announced July 6 the launch of a joint task force to develop solutions to address the growing opioid epidemic, with an eye toward ways physicians and hospitals can play a more active role in tackling this issue. The task force will focus on driving appropriate prescribing and other best practices to help reduce prescription opioid addiction and overdose, also advancing key legislative proposals and policy initiatives.... Read More >>

UW launches webcast series on psychiatry and addiction case consultation

The UW Psychiatry and Addictions Case Consultation series (UW PACC) is a new program designed to expand the mental health and addictions care capacity of health care professionals in remote, underserved areas of Washington. The program offers telehealth resource support to build the confidence and skills of providers who care for patients with mental, addictions, and behavioral health conditions.... Read More >>

L&I launches incentive program for light work following on-the-job injury

The Department of Labor & industries (L&I) has launched the “Stay at Work” Program, which provides financial incentives to state fund employers who bring their injured workers back to light duty following an on-the-job injury claim.... Read More >>

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