Webinar on New State Law: Payment for and Delivery of Hospital Services for Inmates and Persons Detained by Law Enforcement

October 9, 2015

Webinar 12:00 p.m. October 15, 2015

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.)

Senate Bill 5593 addresses two important issues related to care for people in law enforcement custody: guarding and payment. The bill requires that when law enforcement accompanies patients who are in custody for a violent offense or a sex offense into the hospital, law enforcement must continue to accompany or secure the patient, except in certain situations. The bill also establishes a default payment rate for hospital services that is the responsibility of the law enforcement jurisdiction. The webinar will provide an overview of the key provisions of the bill, as well as discussion of implications for hospitals and law enforcement entities. It will be particularly useful for emergency department leaders, legal counsel and financial staff.

The webinar is scheduled for Thursday, October 15, from 12:00-1:00 p.m. The login information is below.

Topic: Senate Bill 5593 Implementation
Date: Thursday, October 15, 2015
Time: 12:00 pm, Pacific Daylight Time
Session number: 804 473 092
Session password: sen1015

CONNECTION INFORMATION:  JOIN THE WEB PORTION FIRST

  • Go to https://wsha.webex.com/wsha/ .
  • Enter your name and email address.
  • Enter the session password: sen1015, and click “Join Now”.
  • Enter your phone number on the pop-up screen and the system will call you.

If you are not joining on the Web and need to join by phone only, dial 1-877-668-4490 FREE and access code 804 473 092.

A bulletin detailing the bill is linked here. If you have any questions, please contact Andrew Busz.

WSHA Task Force Digs into Medicaid Budget Neutrality Adjustment Methodology

On October 1, the WSHA Rebasing Task Force heard a webinar from the state’s consultants, Navigant, on the methodology used to ensure budget neutrality in aggregate for the newly rebased inpatient and outpatient Medicaid rates for prospective payment system hospitals. Here are links to the webinar slides and calculation summary. The methodology, to comply with WAC 182-550-3850, uses periodic prospective adjustments to obtain budget neutrality rather than retrospective adjustments or an up-front reduction. The group has asked for some additional information to ensure the method is appropriately calibrating spending differences between the old and new systems. (Andrew Busz)

Website Provides Issues Log for Payor ICD-10 Implementation Issues

A local workgroup of providers and health plans has been working on ICD-10 implementation and transition issues for more than a year and has additional information and resources on a special page of the OneHealthPort website. The website includes a link to an issues log where participating payors will provide updates of specific issues that have been identified and the status of resolution. There have been no such issues identified yet, since few, if any services provided after October 1 and subject to ICD-10 have been billed to payors. Hospitals and other providers experiencing issues may wish to check the “Alerts” section of the web page prior to contacting the plan to see if the issue has already been identified and is in process of resolution. Most payors have indicated they have created internal structures to triage and resolve ICD-10 related issues but are encouraging providers to contact them through their normal provider relations contacts. Hospitals that experience difficulties getting responses from plans may contact Andrew Busz, WSHA Policy Director, Finance for assistance in contacting the payor. (Andrew Busz).

Office of the Insurance Commissioner to Implement New Form to Monitor Contract Health Plan Networks

The Washington State Office of the Insurance Commissioner (OIC) announced details of the adoption process and format of a new standardized form health plans must submit on a monthly basis to document their contracted networks. The new form, required under WAC 284-43-220,will enhance the OIC’s ability to monitor and confirm contractual arrangements and changes to plan networks. Among the form’s data fields is identification of the facility or provider as an essential community provider.

The OIC is soliciting comments about the proposed field modifications for the form. If you are interested in commenting, please direct your comments to the OIC Network Administrator by close of business October 23, 2015 at OICNetworkAccess@oic.wa.gov. (Zosia Stanley)

Recording Available regarding Livanta Review of Short Inpatient Stays

Livanta, the Quality Integrity Organization (QIO) for our region, recently released a recording (to be downloaded) and slides regarding the new review process for short inpatient stays under the Medicare program. Of particular interest to hospitals is the review process for cases where inpatient care is determined medically necessary based on the patient’s clinical condition but does not meet the specific “Two-Midnight” criteria. Under the recently finalized rules from the Centers for Medicare and Medicaid Services, initial reviews of short inpatient stays will be reviewed by Livanta and other QIOs, rather than by the Medicare Administrative Contractors or Recovery Audit Contractors. Under the CMS rule, hospitals with high denial rates may be referred to the RACs for additional review and possible recovery. (Andrew Busz)

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