Health Care Authority revises administrative days policy

September 24, 2015

After discussions with WSHA, the Washington State Health Care Authority (HCA) recently announced it will revise its policy on administrative days and return to the longstanding policy it used previously. This revision will ensure hospitals are paid for days where a patient has completed an inpatient stay and no longer meets inpatient criteria, but transfer to an appropriate post-acute care such as a skilled nursing facility is delayed due to capacity issues. WSHA and member hospitals had sought clarification as HCA had been denying these additional stays and forcing hospitals to absorb these costs.

HCA affirmed that authorized services would be paid the administrative day rate. HCA is revising the provider billing guide, due Oct. 1, to reflect the change and will also provide additional detail on criteria and billing. We are pleased HCA agreed to the policy clarification and thank staff from various hospitals who helped us provide information to support the revision.

Read more in the Sept. 16 edition of Fiscal Watch. (Andrew Busz)


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