Insurance Commissioner Considering Rule Changes for Prior Authorizations: Your Input Needed!

In response to provider and enrollee concerns, the Office of the Insurance Commissioner (OIC) announced it is considering rule-making to provide more specific requirements related to health plan prior authorizations. The rules would provide make the prior authorization process more predictable and transparent, and they would minimize the burden of the process on consumers.... Read More >>

WSHA encourages hospitals to complete AHA/FHA survey on rising drug costs

WSHA, the American Hospital Association (AHA) and other hospitals groups are concerned about the effect rising drug costs are having on hospital budgets and hospital costs, particularly if drugs are bundled as part of a hospital prospective payment methodology.... Read More >>

How Remote Patient Monitoring Can Impact Hospital Readmissions

Washington Hospital Services Industry Partner HealthVUE has written a piece on the positive impact remote patient monitoring (RPM) can have on reducing hospital readmissions.... Read More >>

HCA Provides Webinar Slides for Potentially Preventable Readmissions Program

On April 28 the Health Care Authority hosted a webinar on its Medicaid program on potentially preventable readmissions. Under this program, effective January 1, 2016, the state applies a prospective reduction to each hospital’s Medicaid inpatient payment rate based on that hospital’s rate of potentially preventable readmissions.  As part of this program, HCA sends each... Read More >>

WSHA, Member Hospitals Address Under-reporting of DSH Medicaid Days

WSHA is working with the Health Care Authority (HCA) to address an issue causing a possible under-reporting of Medicaid days used on hospital Medicare cost reports. An under-reporting of days can result in loss of Medicare disproportional share hospital (DSH) payments.... Read More >>

HCA In Process of Finalizing SFY 2017 Safety Net Assessment Program

The Hospital Safety Net Assessment Program for SFY 2017, which begins July 1, 2016, is expected to be stable and relatively unchanged compared to 2016. WSHA is working closely with Health Care Authority staff to ensure the program continues to work as designed to provide budget savings to the state and funding for Medicaid hospital services.... Read More >>

All Washington Hospitals Asked to Adopt Standard Financial Assistance Applications and Communications

Two weeks ago, WSHA staff held a webinar and sent information to hospital CFOs asking each hospital in Washington to adopt a new, standardized and simplified financial assistance application and communication process. This standardized application was developed at the request of the WSHA Board by a workgroup of WSHA member hospital patient account managers. ... Read More >>

Payment for Medicare Rural Health Clinic claims on hold, awaiting fix

WSHA has been actively following recent developments in Medicare payment for Rural Health Clinics (RHCs). Medicare Administrative Contractors have been instructed temporarily to hold all claims from RHCs for dates of service after April 1, 2016 until a correction is made in the payment file.... Read More >>

WSHA provides hospital resource on state and federal signage & communication requirements

Hospitals are subject to an array of state and federal requirements regarding posting signage in hospitals and providing notices to patients, staff and the community. WSHA has prepared a list of signage requirements for hospitals to reference.... Read More >>

Insurance Commissioner to Begin Rulemaking on Prior Authorizations

Many of our members have expressed frustration with the increasing burden of expanding health plan requirements on prior authorizations. WSHA and the Washington State Medical Association have been in discussions with the health plans directly as well as with the Office of the Insurance Commissioner (OIC). ... Read More >>

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