Legislators Reach Agreement on Budgets, Avoid State Shutdown

Project Access Northwest Expands Insurance Premium Sponsorship Program Statewide

Although thousands of Washington State residents have enrolled in insurance in the last two years, many working families and individuals are still unable to afford their health insurance premiums.
A new program from Project Access Northwest can connect these consumers with additional help to pay their monthly insurance premiums. The Premium Assistance Sponsorship Program is designed for low-income state residents who are eligible to purchase individual health insurance on the Washington State Health Benefit Exchange.

Several Western Washington hospitals and health systems are funding partners, and they refer potential enrollees to the program. In 2015, Project Access Northwest enrolled 130 households with an average premium of about $225 a month. Open enrollment for the Exchange starts again November 1, 2015.Click here for more information from Project Access Northwest.

Please contact Chelene Whiteaker, WSHA Policy Director, Member Advocacy, if you have questions about this exciting program and how your hospital or foundation could participate. (Chelene Whiteaker,chelenew@wsha.org)

OneHealthPort Launches ICD-10 Countdown Website

On July 6, OneHealthPort, a Washington entity working with health plans and providers, added a newCountdown to ICD-10 page to the Administrative Simplification Section of its website. The new page is a source for alerts and training opportunities as hospitals, physician clinics, and other providers prepare for the October 1 implementation. A workgroup of hospitals, physician groups and major payors has met on an ongoing basis for the better part of three years to discuss implementation issues and provide information. The new webpage augments the other information already available on the site.

While all parties are hopeful for a smooth transition to the new code set, hospitals and other providers are concerned about impacts on timeliness of payment from health plans. Under Washington law, health carriers must meet timely payment requirements to avoid incurring interest penalties. If plans are unable to accommodate “clean claims” billed properly under the new code set, they may consider alternative payment arrangements with providers until the situation is remedied. WSHA plans to contact the Office of the Insurance Commissioner do see if they plan to issue additional instructions or clarification. (Andrew Busz, andrewb@wsha.org)

Resources for Recertification of 340B Providers

The Health Resources and Services Administration Office of Pharmacy Affairs is required to annually recertify all participating hospitals enrolled in the 340B Program. This ensures all hospitals are appropriately listed on the 340B database and remain compliant with the 340B Program requirements.  The agency has supplied information regarding the process. (Andrew Busz, andrewb@wsha.org)

340B Annual Recertification: Washington Hospital Services Industry Partner Offers Solution

SUNRx, an industry partner of the Washington State Hospital Association, is available to provide free guidance and expertise through the 340B recertification process. All 340B eligible entities must perform recertification on an annual basis. This process is in place so that the federal Office of Pharmacy Affairs can ensure that all registered covered entities are in fact still eligible for the program. The recertification process is similar to how covered entities initially register their facilities but it is not nearly as extensive of a process as the initial registration.

The biggest issue covered entities face during the recertification process is that their primary contact and authorization information is not up to date. The Office of Pharmacy Affairs sends recertification notices to these contacts. If the information is not up to date, your hospital may not receive its recertification notice information, may miss the recertification period, and may lose 340B eligibility.

Let SUNRx be your guide through this process. They were selected for WSHA industry partnership because of their track record and expertise. If you have any questions about the 340B recertification process or the 340B program in general, please contact Mike Robert with SUNRx atMroberts@sunrx.com or (406) 266-1062. For questions about the WSHA’s Industry Partner program, please contact Paul Unsworth, Washington Hospital Services Business Relations Director, atpaulu@wsha.org or (206) 577-1806. (Paul Unsworth, paulu@wsha.org)