Proposed Medicare Inpatient Rule Includes 2.8 Percent Rate Increase

The Centers for Medicare & Medicaid Services (CMS) April 10 issued its hospital inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS proposed rule for fiscal year (FY) 2024. WSHA... Read More >>

Final Medicare Advantage Rule Places Greater Oversight and Restrictions on MA Plans

The Centers for Medicare & Medicaid Services (CMS) April 5 finalized its Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Program for Contract Year (CY)... Read More >>

WSHA, unions reach compromise on staffing bill

After weeks of negotiations, we are pleased to report we have reached a compromise on SB 5236 – the staffing bill that would have mandated nurse-to-staff ratios. Most notably, there... Read More >>

No Surprises Act arbitration resumes, but only for services prior to October 25, 2022

The Centers for Medicare and Medicaid Services (CMS) has instructed Independent Dispute Resolution (IDR) entities for the federal No Surprises Act to resume arbitration proceedings, but only for payment disputes... Read More >>

OIC extends Balance Billing Protection Act arbitration process until at least January 1, 2024

On a related note, the Washington State Office of the Insurance Commissioner recently announced that the dispute resolution mechanism under the state’s Balance Billing Protection Act (BBPA) would be extended... Read More >>

WSHA and AWPHD Report on 2022 Lobbying Expenses for Adjusting Medicare Cost Reports

The Medicare Provider Reimbursement Manual requires hospitals to adjust their Medicare cost reports to deduct the portion of association dues related to lobbying expenses. WSHA and AWPHD recently calculated and... Read More >>

OIC issues final rule implementing HB 1688 Balance Billing

The Washington State Office of the Insurance Commissioner (OIC) issued its final CR-103 rule to implement E2SHB 1688. The rule aligns portions of the state’s Balance Billing Protection Act as... 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... Read More >>

Revenue forecast indicates short term gains, long term challenges

The revenue forecast released by the Washington State Economic and Review Forecast Council on November 18 indicated short term revenue increases, but a cautious longer range outlook. The forecast, including... Read More >>

PPS 340B hospitals must resubmit 2022 claims for drug payment correction

Earlier this year, the US Supreme Court overturned cuts made by the Centers for Medicare and Medicaid Services to PPS hospitals for hospital administered drugs under the 340B program. For... Read More >>

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