Inside Olympia: Budget picture continues to be gloomy

February 4, 2019

While revenue collections in the state continue to be strong, it appears that policy decisions made to fund future costs in the McCleary bill in the 2017-2019 biennium have led to the inability to spend money on any additional policy items without new revenue or cuts in other programs. These future costs include about $4.1 billion of increased spending for K-12 education. In addition to these extraordinary K-12 costs, other expenses will occur because of caseload increases, loss of federal funding at Western State and the Trueblood decision regarding the state’s responsibility for forensic services. This budget picture is much more dire than legislators expected coming into the 2019 session. We expect the Senate and House to release their versions of the budget in March.

SB 5031 & SB 5699: Balance billing

WSHA will be testifying on SB 5031 and SB 5699, which prohibits providers from using balance billing in certain circumstances for out-of-network services. The bills will be heard Monday, Feb. 4 in the Senate Committee on Health & Long Term Care. If balance billing is prohibited, there must be a clear mechanism via patient insurance cards and payment statements to identify the relevant carrier groups and self-funded groups. Further, any process with an arbitrator to determine “commercially reasonable” payment should not include Medicare payment rates, which are not applicable. WSHA will seek to amend SB 5031, the Insurance Commissioner’s bill to include these changes. SB 5699 includes more of the provisions we are hoping to see in a final compromise, and we support it. WSHA supports efforts to protect patients from unforeseeable, unexpected billings.  Read our issue brief. (Andrew Busz)

Transitioning developmentally disabled patients out of hospitals: Work session and SB 5483

The Senate Committee on Health & Long Term Care will hold a work session on transitioning patients with developmental disabilities out of hospitals. WSHA will testify in the work session, and we support the efforts to transition these patients out of hospitals and into more appropriate sites of care.

WSHA supports SB 5483, which institutes regulations to track when developmentally disabled patients are hospitalized without medical need and requires the Developmental Disabilities Administration to provide crisis stabilization services before a developmentally disabled patient is discharged. It also requires the Developmental Disabilities Administration to coordinate the patient’s transition to a more appropriate care setting and reimburse hospitals that care for these patients. (Zosia Stanley)

HB 1531: Medical debt

WSHA opposes HB 1531, which places restrictions on interest for medical debt. Specifically, it would reduce the interest rate for both pre and post-judgment interest on medical debt from 12 percent to 2 points above the federally set prime rate, which would currently be about 7 percent. It also places significant limits on amounts available for garnishments. The bill will be heard Wednesday, Feb. 6 in the House Committee on Civil Rights & Judiciary.

The use of pre-judgment and post-judgment interest is an important tool for creditors to collect the amounts they are owed for the services provided. If medical debt is singled out as less important, hospitals will have difficulty collecting from patients who can and should pay their portion of a bill. Hospitals, particularly those that receive taxpayer support, have a fiduciary responsibility to collect from patients who can pay.

WSHA has worked as part of a stakeholder group to explore options to ease some of the burden that medical debt places on consumers. In addition to WSHA, the workgroup included the Washington State Medical Association, Columbia Legal Services and the collections community. Together, we reached compromises that:

  • Prohibit bench warrants on medical debt
  • Prohibit sending medical debt to collections until 120 days after the first bill
  • Require collectors to provide notice before assessing prejudgment interest
  • Prohibit collectors from making adverse credit reports for 180 days after the debt is assigned
  • Require collectors to offer information about charity care collections efforts if a charity care application is pending

Though we oppose the bill, we support the use of these compromises, which are included as part of the bill. Read our issue brief on the larger issue of medical debt. (Zosia Stanley)

HB 1491: Concerning employer and employee scheduling

WSHA opposes HB 1491, which would impose a number of obligations on employers relating to their scheduling of employees. The bill specifically identifies employers in the food service, retail and hospitality industries, but as currently drafted, all employers would effectively be captured, including hospitals. (Jaclyn Greenberg)

See you Thursday for Hospital Advocacy Day!

This Thursday, Feb. 7, is Hospital Advocacy Day in Olympia, and we look forward to seeing you there. We are excited that 70 members representing 35 Washington hospitals have RSVP’d to be in attendance. We will spend the day advocating for our priority initiatives, talking with legislators and telling the hospital story. We will see you there! (Lori Martinez)

WSHA Legislative Testimony: Feb. 4-8

Monday, Feb. 4

  • Senate Health & Long Term Care
    • SB 5031 (see balance billing article above, Andrew Busz)
    • SB 5405 concerns nondiscrimination in access to organ transplants (Andrew Busz)
    • SB 5699 (see balance billing article above, Andrew Busz)

Tuesday, Feb. 5

  • House Labor & Workplace Standards
  • Senate Labor & Commerce

Wednesday, Feb. 6

  • House Human Services & Early Learning
    • HB 1874 relates to recommendations on parent-initiated treatment for adolescents (Jaclyn Greenberg)
  • House Civil Rights & Judiciary
  • House Health Care & Wellness
  • Senate Health & Long Term Care
    • SB 5483 (see article above about individuals with developmental disabilities, Zosia Stanley)

Thursday, Feb. 7

  • House Labor & Workplace Standards
  • Senate Labor & Commerce
    • SB 5295 concerns labor neutrality and contractor compliance for certain contracted service providers (Jaclyn Greenberg)

Friday, Feb. 8

  • House Civil Rights & Judiciary
    • HB 1678 allowing involuntary treatment act evaluations by video (Jaclyn Greenberg)
  • Senate Behavioral Health Subcommittee to Health & Long Term Care
    • SB 5045 integrates risk for long-term civil involuntary treatment into managed care (Shirley Prasad)
    • SB 5431 concerns Certificate of Need exemptions (Shirley Prasad)
  • Senate Health & Long Term Care


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Washington State Hospital Association
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