WSHA requests additional info on HCA payment rate reductions

November 5, 2015

WSHA has been working hard to verify the appropriateness of the recent Health Care Authority (HCA) proposed reductions for payment rates for Prospective Payment System (PPS) hospitals. The HCA recently sent PPS hospitals notices of new Medicaid inpatient and outpatient payment rates, effective Nov. 1, 2015. The rates include an 8 percent reduction for inpatient rates and an 8 percent reduction for outpatient. These changes are due to state calculations to ensure budget neutrality with the payment rates in effect prior to the July 1, 2014 rebasing.

WSHA has requested that HCA and its consultant, Navigant, provide additional information regarding the calculations. WSHA has also hired Analysis Group, our consultant for the safety net assessment program, to review the state’s methodology and calculations for reasonableness. WSHA will inform members of the results of the review. In the meantime, we believe hospitals should file a rate appeal with HCA. Click here to read more in our recent Bulletin. (Andrew Busz)


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