Last session the state enacted a law, HB 2572, creating an all-payer claims database. With last-minute political maneuvering, the law as passed was flawed. The law has no mandate on private insurers to submit claims to the database –the only mandate is for health plans that contract with the state. There is also a requirement that... Read More >>

We have heard from many of you about issues with the Health Care Authority’s (HCA) programming of Enhanced Ambulatory Payment Groups (EAPGs)  related to implementation of the new  payment system implemented July 2014. The errors caused significant numbers of outpatient prospective payment hospital Medicaid claims to be underpaid or denied. HCA has agreed that as programming... Read More >>

The Washington Health Benefits Exchange (Exchange) announced this week it would be giving people two more months – until April 17 – to enroll for 2015 coverage in qualified health plans. This special enrollment period applies to people that have experienced technical problems or just recently discovered the financial impacts of the individual mandate. Recently, the Exchange experienced a... Read More >>

Court Victory May Impact Medicaid DSH Payments A recent court victory by Seattle Children’s Hospital and Texas Children’s Hospital may significantly impact how Medicaid Disproportionate Share Hospital (DSH) payments are distributed by Washington State and other states. The Washington State Health Care Authority is in the process of analyzing the details of the injunction.  ... Read More >>

Exchange Open Enrollment Continues Through February 15, 2015 The Exchange is currently enrolling people for subsidized commercial insurance through February 15, 2015, through the Washington Healthplanfinder. Enrollment in Apple Health (Medicaid) is not subject to the open enrollment period, and eligible recipients can be enrolled at any time. WSHA urges hospitals to continue their outstanding efforts to... Read More >>

2014 was a year of significant changes for hospitals and healthcare, impacting both health care coverage and payment issues. Here are a few of the significant events that occurred this year.... Read More >>

The Health Care Authority (HCA) has completed changes that should help many hospitals obtain significant additional Medicare disproportionate share hospital funding. WSHA became aware that HCA’s process for counting and reporting Medicaid days for the period from January 1, 2011 through December 2013 did not include days for patients covered by Basic Health and Disability Lifeline... Read More >>

As part of the process to develop a budget proposal for the upcoming biennium (State Fiscal Years 2016 and 2017), the Health Care Authority’s (HCA’s) recommendations to the Governor included a cut to the Medicaid payment rates for hospital-based clinics of $42 million over the two-year period. (See a hospital-specific estimate of the impact of this cut.) While we... Read More >>

  The Washington State Health Care Authority (HCA) and the Department of Social and Health Services (DSHS) are in the process of determining the regional boundaries they will use for purchasing mental health and substance use disorder services in the future.  The state has released its proposed regional service area boundary plans dividing the state... Read More >>

New Safety Net Assessment Program Successfully Completes First Year The Washington State Hospital Association (WSHA) is pleased to report that payments to hospitals for Medicaid services under the Hospital Safety Net Assessment program have been made by the state and the managed care plans for state fiscal year (SFY) 2014. WSHA has worked with the... Read More >>