New HCA resources on Accountable Communities of Health: FAQ and conference calls

The state Health Care Authority (HCA) released a new Frequently Asked Questions document and announced monthly conference calls to answer questions and provide general updates on the Accountable Communities of Health (ACHs).... Read More >>

WSHA Provides Reports and Analyses of Medicare Outpatient Rule to Hospitals

On November 20, WSHA provided hospitals with an analysis of the Calendar Year 2016 Medicare outpatient prospective payment system final rule. WSHA also provided facility-specific impact reports to hospital Chief Financial Officers. The new payment rates include a 2.1 percent market basket increase that is offset by an ACA-mandated reduction of 0.7 percent and an additional adjustment reduction of 2 percent due to lab services that should have been bundled being paid separately in error. ... Read More >>

Insurance Commissioner Plans Balance Billing Legislation

Washington State Insurance Commissioner Mike Kreidler plans to submit proposed legislation in the upcoming 2016 session to limit balance billing of patients for out-of-network emergency services when a patient receives care at a facility contracted as in-network with their health plan.... Read More >>

HCA Incorporates WSHA Comments into Final Rule for Early Obstetrical Deliveries

The final rule for payment of early obstetrical deliveries adopted by the Washington State Health Care Authority (HCA) includes protections requested by WSHA for patients and providers. The rule is intended to deny Medicaid payment for early elective deliveries. The final rule allows payment for deliveries prior to 39 weeks if the early delivery is medically necessary.... Read More >>

Health Care Authority to Adjust November 1 Rate Cut for PPS Hospitals

On November 1, the Washington State Health Care Authority (HCA) reduced inpatient and outpatient hospital payments to prospective payment hospitals by 8 percent in order to apply budget neutrality adjustments due to the recent rebasing of the payment systems. In response to this significant change in Medicaid rates, WSHA requested HCA and its consultant, Navigant, review the calculations and provide WSHA with data sets to enable an independent analysis.... Read More >>

Mental health capital grants announced

Recognizing the continuing need for involuntary inpatient mental health services, the state Legislature funded $32 million in the 2015-2017 budget for capital grants to assist with construction or renovation for inpatient and crisis mental health services.... Read More >>

Hospital financial assistance webinar recording available

WSHA hosted a webinar Nov. 23 on important information about development of a standard financial assistance application form and standard financial assistance communication plan for Washington State hospitals. Please contact Cliff Duggan if you are interested in receiving a copy of the recorded webinar. You can reach Cliff at CliffD@wsha.org or (206) 216-2517. WSHA recommends every hospital review this the application and communication plan. These documents are still in draft form, and WSHA welcomes feedback by Dec. 1.... Read More >>

Clinical experts needed for state Disaster Medical Advisory Committee

On Jan. 1, 2015 the Washington State Department of Health launched a planning effort to create a state-level structure for clinical engagement on issues related to Crisis Standards of Care during an emergency of state-level importance. The need for regional medical surge planning that incorporates the ability to implement regional crisis standards of care is recognized by many local, state and federal agencies.... Read More >>

CMS Announces Recovery Audit Contractor Program Improvements

After several years of frustration and advocacy, hospitals should soon see meaningful reform to the Recover Audit Contractor (RAC) program. Effective January 1, the amount of audit requests RACs will be able to request for a hospital will be reduced by three-fourths, from 2.0 percent down to 0.5 percent of the hospital’s paid Medicare claims from the previous year.... Read More >>

WSHA Provides Rate Appeals Guidance and Webinar Slides for November 1 Medicaid Cuts

The Health Care Authority recently sent Prospective Payment System (PPS) hospitals notices of new Medicaid inpatient and outpatient payment rates, effective November 1. These changes are due to state calculations to ensure budget neutrality. ... Read More >>

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