The Washington State Health Care Authority (HCA) is beginning the process of updating the Medicaid payment methodology for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics. HCA is in the final stages of contracting with a technical assistance consultant to work with stakeholders to develop a successor to the current alternative payment methodology (APM).... Read More >>

On November 16, the Centers for Medicare & Medicaid Services (CMS) finalized its rule concerning payment of hip and knee replacements for hospitals in selected regions. The new program goes into effect April 1, 2016 and will affect hospitals in the Seattle-Tacoma-Bellevue and Portland-Vancouver-Hillsboro metropolitan service areas that provide hip and knee replacement surgery.... Read More >>

The Health Care Authority (HCA) recently sent hospitals new agreements to provide protections from reductions to regular Medicaid payment for the period when hospitals are participating in the Hospital Safety Net Assessment program. The new safety net law, passed during the most recent legislative session, requires HCA to offer hospitals an agreement giving the hospital a remedy should the state reduce payments under the program.... Read More >>

It’s that time again! Open enrollment for the Exchange’s individual market runs November 1, 2015 to January 31, 2016. Washington’s hospitals play a key role in helping patients enroll in either the Health Benefit Exchange’s subsidized health plans or Apple Health, depending on the enrollee’s income. Individuals and families can access enrollment for either program through Washington’s Healthplanfinder portal. ... Read More >>

Please join the Washington State Hospital Association, the Washington Association of Sheriffs and Police Chiefs, and the Association of Washington Cities for a webinar about important changes in Washington State law as a result of enactment of Senate Bill 5593,which went into effect July 24, 2015. This webinar is for hospital staff and staff of law enforcement entities and governing units affected by the bill. (The webinar will be recorded.)... Read More >>

Special Fiscal Watch   Because of an error in the calculation of the assessment amounts, the Health Care Authority is reissuing the assessment invoices for the first quarter of State Fiscal Year 2016. You should have received their announcement (below) along with a corrected invoice. WSHA worked closely with HCA on this issue and agrees... Read More >>

After discussions with WSHA, the Washington State Health Care Authority (HCA) recently announced it will revise its policy on administrative days and return to the longstanding policy it used previously. This revision will ensure hospitals are paid for days where a patient has completed an inpatient stay and no longer meets inpatient criteria, but transfer... Read More >>

At the very end of the 2015 legislative session and after an extraordinary amount of negotiation and fine-line review, both the House and the Senate passed, and the Governor signed, HB 2151, a new Hospital Safety Net Assessment bill that meets the parameters established by the WSHA Board of Trustees. Operationally, the program will function in... Read More >>

Last week the Washington State Health Care Authority (HCA) sent providers an alert clarifying that HCA will not be adopting a policy adopted for Medicare Part B contractors regarding specificity of diagnosis coding of claims under the new International Classification of Diseases, Version 10 (ICD-10). HCA will require that as of the October 1, 2015 implementation date,... Read More >>

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule requiring prospective payment hospitals that provide hip and knee replacements in selected metropolitan areas to participate in a new bundled payment initiative. Read the proposed rule here. Hospitals will be responsible for the quality and cost of an episode of care ending... Read More >>