Billing for Opioid Reversal Medication for Uninsured Patients

The Washington Health Care Authority has provided a form and billing instructions for hospitals and behavioral health facilities to be reimbursed for opioid reversal medication provided to uninsured patients as a result of Substitute Senate Bill 5195. WSHA worked with legislators and the HCA to ensure hospitals could be reimbursed for the cost of the medication. These expenses can be... Read More >>

WSHA Provides Draft Comments on Medicare Outpatient Proposed Rule

Comments on the Centers for Medicare and Medicaid Services (CMS) proposed outpatient rule are due September 13. WSHA will submit comments by the deadline and has provided a draft of its comments to member hospitals. WSHA’s letter includes comment on the following areas: Proposed marketbasket and productivity adjustments 340B hospital payments Site-neutral clinic visit cuts Hospital outpatient outlier payments... Read More >>

OIC Provides Second Prepublication Draft of Balance Billing Protection Act Rules. Comments due September 13

The Washington State Office of the Insurance Commissioner (OIC) has issued a second prepublication draft of rulemaking to implement E2SHB 1688. The proposal aligns portions of the state’s Balance Billing Protection Act with the federal No Surprises Act.  In response to WSHA’s concerns, the second prepublication draft includes changes to the definition of outpatient hospital department. We are... Read More >>

WSHA Updates Regulatory Rulemaking Page

WSHA’s Government Affairs team recently published an update to its Top Priority Rules Tracker, which shows the highest-priority ongoing state rulemaking activities impacting hospitals and health systems as part of its State Regulatory Issues webpage. Members will find a comprehensive view of the status of state rulemaking activities that affect them and the appropriate WSHA staff contact. Currently,... Read More >>

WSHA Urges Definition Clarification in Balance Billing Rule

WSHA commented on a recent preproposal draft rule for E2SHB 1688 which was passed during the 2022 legislative session. E2SHB 1688 aligns the state’s Balance Billing Protection Act with the federal No Surprises Act and adds balance billing protections for emergency and crisis behavioral health services. WSHA commented that the definition of “outpatient hospital department”... Read More >>

WSHA Asks for Important Changes on the HCA Telemedicine Rule

WSHA commented on the Health Care Authority’s (HCA) preproposal draft rule for ESSB 1196, which was passed during the 2021 legislative session. ESSB 1196 builds on Washington state’s telemedicine payment parity law by requiring reimbursement for audio-only telemedicine to be paid at “the same amount of compensation the carrier would pay the provider if the health... Read More >>

Federal Agencies Release Interim Final Rule on NSA Dispute Resolution Process

Last Friday, the U.S. Department of Labor (DOL), the Department of Health and Human Services (HHS) and the Department of the Treasury released their interim final rule on the independent dispute resolution process under the federal No Surprises Act (NSA). The NSA dispute resolution process applies to payment disputes between hospitals and providers and insurers... Read More >>

Non-CPE DSH Application Deadline is September 1

Preliminary non-CPE Disproportionate Share Hospital (DSH) applications for state fiscal year 2023 must be submitted to Health Care Authority or before September 1, 2022 to receive consideration for the SFY 2023. The application applies to the state’s low-income and small rural DSH programs. To preserve consideration, hospitals must submit initial DSH applications with basic information... Read More >>

Recertification Period for 340B Eligibility Opens

The annual 340B Program Recertification period for Hospitals will be August 24-September 19, 2022. The Office of Pharmacy Affairs (OPA) of the federal Health Resources and Services Administration (HRSA) requires covered entities to recertify in order to remain in the 340B Program. Registration must be recertified each year by the entity’s Authorizing Official (AO) or... Read More >>

WSHA Advocacy on Hospital Financial Challenges

WSHA’s efforts to raise awareness of hospital’s unprecedented capacity and financial challenges are having an impact. WSHA sent a letter to all state legislators and health care regulators detailing the financial losses and reasons for them. In response to voicing our growing concerns about patient who are unable to be discharged, we received a letter... Read More >>

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