PARA HealthCare Provides Insight Into CMS Payment Delay for Codes G0477‐G0483 and 90360

Washington Hospital Services Industry Partner PARA HealthCare has written an article about some of the consequences relating to the delay in payment by CMS for drug screen codes G0477-G0438 and Flu vaccine 90360, and is offering some solutions. ... Read More >>

State Budgets to be Released Soon

While the legislature continues to debate hundreds of policy bills, budget writers are also focusing on crafting a supplemental budget for 2016-2017. The legislature enacted a biennial budget for 2015-2017, ... Read More >>

Save the Date: February 23 WSHA Hosting Webinar on New State-Sponsored Health Information Exchange

The Washington State Health Care Authority (HCA) and OneHealthPort will provide an overview of Washington Link4Health, an HCA initiative to advance the statewide electronic exchange of clinical records. HCA is working with OneHealthPort, the designated statewide health information exchange, to introduce Washington Link4Health’s first statewide service. The one‑hour webcast will be held Tuesday, February 23, 2016, noon to 1 p.m. ... Read More >>

WSHA Member Testifies Regarding Emergency Services Balance Billing

On January 20, House Bill 2447 Emergency Balance Billing was heard by the House Health Care & Wellness Committee. The bill, requested by the Office of the Insurance Commissioner, is intended to protect patients from unexpected charges in cases where they receive emergency care at a hospital that is contracted with their health insurer, but not all physicians providing professional services are contracted with that plan.... Read More >>

Recent WSHA Bulletin Reports Good News on Medicaid Rate Adjustments

As reported in a recent WSHA bulletin, the Washington State Health Care Authority (HCA) has agreed to increase inpatient rates for the next quarter by about 18 percent. This restores errors it made to the budget neutrality adjustment factor (BNAF) rates during the last two quarters for Prospective Payment System hospitals and Certified Public Expenditure hospitals.... Read More >>

HCA provides billing instructions for elective obstetrical deliveries

The Health Care Authority has revised both its inpatient hospital and physician-related services provider billing guides to reflect changes to its policy regarding payment for elective early deliveries. Effective January 1, 2016, HCA will not pay for professional or hospital charges related to elective early deliveries before 39 weeks gestation, unless the physician documents that the early delivery is medically necessary. ... Read More >>

AHA submits comments to CMS regarding Medicare Observation Care Notification Act

Under a federal law passed last summer, hospitals may need to provide written and oral notification to Medicare patients placed in observation status as early as August 2016. Unfortunately, the federal rulemaking process may leave little time for hospitals to implement the requirements once the specific requirements are known. The Centers for Medicare and Medicaid Services (CMS) has not yet released its proposed rule for comment.... Read More >>

HCA extends deadline to apply to offer joint replacements with bundled payment

The Health Care Authority has extended its deadline to February 1 for providers to apply to offer total joint replacements using bundled payments for its coverage for state employees. The proposal, based on the episode of care established by the Bree Collaborative, includes establishment of patient disability and failure of more conservative treatment, determination of fitness for surgery, use of evidence-based surgical practices, and standardized post-operative care.... Read More >>

January Medicaid inpatient rates reflect new HCA readmissions policy

Medicaid inpatient hospital payment rates for Washington hospitals paid on the prospective payment system now incorporate penalties based on “excessive” rates of hospital readmissions. A number of hospitals will see small reductions in payment because of this change – with penalties ranging from 0.0 percent to a maximum of 1.0 percent. The new policy from the Health Care Authority penalizes hospitals that appear to have an excessive number of potentially preventable admissions, based on an HCA analysis using 3M Corporation software.... Read More >>

WSHA continues work with HCA on corrections to Medicaid budget neutrality adjustments

On November 1, 2015 the Washington State Health Care Authority (HCA) made an 8 percent reduction in inpatient Medicaid payment rates. There appears to be material errors in the November calculation. As a result of questions that WSHA raised, HCA informed us it discovered an error in the inpatient calculation related to how it priced payments for certified public expenditure hospitals.... Read More >>

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