HCA Responds to WSHA Letter Regarding COVID-19 Funding

May 20, 2020

On April 7, WSHA urged the Washington State Health Care Authority (HCA) to use the increase in the federal match rate from new COVID laws to increase payments to hospitals and providers caring for COVID-19 Medicaid patients. In the letter, WSHA asked HCA to ensure payments for COVID-19 inpatient services and testing services reasonably reflect the hospital’s cost to provide these services. In its response, HCA indicated it was correcting issues with the state’s APDRG grouper to enable payment of claims with COVID-19 diagnoses and would be providing a 20 percent add-on payment for COVID-19 inpatient stays, consistent with Medicare payment policy. HCA is also reviewing its payment to hospitals for COVID-19 testing under the Outpatient Prospective Payment System (OPPS) methodology. WSHA has expressed concerns that often hospitals must pay labs directly for COVID-19 testing, and as a result may not be receiving adequate payment for testing costs under OPPS bundled payment. (Andrew Busz, andrewb@wsha.org)


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