House and Senate Submit Revised Budget Proposals, but Key Differences Remain

June 5, 2015

The dominant parties in the House and Senate released new budgets in the past week: The Senate Republicans released a new budget on Thursday, and the House Democrats did the same on Monday.
The new Senate budget includes new revenue from cannabis and the federal government, but does not make the needed changes to the Hospital Safety Net Assessment. The Senate maintains its proposal to increase the daily assessment amount in order to take more dollars into the state general fund. In total, the Senate proposal increases the amount taken by the state by $47 million more for the state general fund and $20 million more for increased residency slots. 
Read a deeper analysis in Inside Olympia.

The new House budget maintains the Hospital Safety Net Assessment as originally drafted and supported by WSHA. With the increased revenue projections, the House does increase funding for mental health services, including an additional $3.4 million for the additional outpatient services created by HB 1450. The only decrease in WSHA’s preliminary review was to the Health Benefit Exchange, whose funding was decreased by $10 million to $115 million.
The clock on the second special session is ticking; it is scheduled to last nearly until the end of June. Legislators will continue working to beat that deadline. The next fiscal year starts July 1. There is a great deal of uncertainty about how state government will function if there is no budget in place. This has not happened in Washington State before, but it would result in the closure of many state services. (Andrew Busz,

July 1 Hospital Financial Assistance Webinar – Important Information on State Charity Care Law and Federal 501(r) Regulations

WSHA will host a webinar on Wednesday, July 1, 2015 from 2:00 pm to 3:30 pm on hospital financial assistance policies and procedures. The webinar is part of WSHA’s efforts to provide helpful and detailed information to hospital members. Presenters will include Taya Briley and Zosia Stanley from WSHA, Barbara Shickich from Riddell Williams, and David Lawson from Davis Wright Tremaine.

The webinar will include review of Washington State’s charity care law, education on important changes in federal law for 501(c)(3) hospitals, and guidance on compliance with both state and federal laws. There will also be a discussion of WSHA’s work with members to develop a model charity care application form and model communication plan. This is an important topic for all Washington state hospitals, and we encourage attendance. This webcast is intended for WSHA members only.

If you are interested in attending, please contact Zosia Stanley at

WSHA Provides Hospital-Specific Medicare Analyses

WSHA recently sent summaries and hospital-specific impact analyses of several proposed Medicare rules on rate updates for federal fiscal year 2016 for inpatient, skilled nursing facilities, and inpatient rehabilitation. The reports are generally sent to the Chief Financial Officer or CFO contact for each hospital or system. Hospital finance staff not currently receiving these reports can make arrangements through their CFO. The American Hospital Association will be submitting comments on these proposed rules. WSHA also comments if there are specific concerns to Washington hospitals.

Inpatient PPS: On a national basis, rates are projected to remain flat. For Washington State, the proposed rules result in an average increase of 1.5 percent but the impact ranges from a negative 2.6 percent to a positive 6.4 percent. Among the regular updates, this proposed rule includes several different areas, each modeled in the hospital-specific analysis, on value-based purchasing, readmissions reduction, hospital acquired conditions, penalties for non-compliance with the electronic health record program, and disproportionate share hospital payment policies.

Inpatient Rehabilitation:  The proposed rule reflects the annual update to the Medicare fee-for-service IRF payment rates and policies. On a national basis, the proposed rule would increase payments by 1.5 percent. For Washington State, the increase averages 3.1 percent but ranges from 0.6 percent to 5.9 percent.

Skilled Nursing Facilities:  CMS estimates the overall economic impact of this proposed rule to be $500 million, an increase of 1.4 percent, in aggregate payments to SNFs. For Washington State, the increase averages 2.9 percent for hospitals with a skilled nursing facility but ranges from 2.5 percent to 7.3 percent.

If you have comments or questions, please contact Jonathan Bennett at or Andrew Busz at

Senators Cantwell and Murray Introduce Bill to Improve Payment Models for Rural Health Care Organizations

A few weeks ago, with input from WSHA, U.S. Senators Maria Cantwell and Patty Murray introduced a bill to improve Medicare Accountable Care Organizations for patients and health care providers in rural areas. The bill, The Rural ACO Improvement Act of 2015, promotes access to coordinated, patient-focused health care in rural and underserved areas by making ACO assignment more accurate and inclusive in communities lacking primary care physicians.

The bill allows Medicare ACOs to include primary care visits by nurse practitioners, physician assistants and clinical nurse specialists. It also allows for primary care services to be offered in federally-qualified health centers and rural health clinics.

Read the full press release here. We strongly support this legislation, and thank our Senators for their leadership. WSHA members can contact Cassie Sauer at (206) 216-2538 or John Flink at (406) 439-1698 with questions about our federal advocacy agenda and programs.



Contact Us

Washington State Hospital Association
999 Third Avenue
Suite 1400
Seattle, WA 98104

Map / Directions

206.281.7211 phone
206.283.6122 fax

Staff List