State Regulatory Issues

State regulations have a big impact on hospitals, health systems and their patients. WSHA tracks rulemaking activity throughout the state and works closely with regulatory agencies, as well as other groups, to advocate for a reasonable regulatory environment. All statewide rulemaking activity is published in the Washington State Register.

Click here to see WSHA’s Top Priority State Rules Tracker

(Updated: February 8, 2021)

There are several regulatory issues at the top of WSHA’s priority list for February, including:

Trauma Centers– The Department of Health issued a CR 101 preproposal announcing a review of the criteria for designating trauma centers that will lead to further criteria development. According to the preproposal this rulemaking process “will help ensure that Washingtonians have optimal access to trauma care services while helping to maintain a healthy system that balances access with other important considerations, such as maintenance of subspecialty volume and patient outcomes.” WSHA will provide updates as this rulemaking progresses. (Alicia Eyler)

Psychiatric Per Diem Rates – The Health Care Authority issued its final rule to increase psychiatric per diem rates for community hospitals that serve patients in long-term inpatient psychiatric care. The CR 103 sets two different rates:

(i) For a hospital that has a Medicare cost report on file with the agency for the most recent filing year, the rate is set using hospital specific costs or nine hundred forty dollars, whichever is greater.

(ii) For a hospital that does not have a Medicare cost report on file with the agency, the rate is set using the average of all in-state long-term psychiatric per diem rates based on provider type or the hospital’s current short-term psychiatric per diem rates, whichever is greater.

The rates are effective February 6, 2021. (Shirley Prasad)

Physician Assistant Practice Act Implementation– The Washington Medical Commission (WMC) is designing rules to implement the new PA Practice Act. The CR 101 preproposal states WMC is “updating the PA chapter to more closely align with current industry standards, modernize regulations to align with current national industry standards and best practices, and provide clearer rules language for licensed PAs.” WMC held its first rules development workshop on January 13, 2021 and has issued draft language for public comment. The deadline for commenting is March 31, 2021 and comments should be sent to Additionally, the next rules development workshop is tentatively scheduled for April 7, 2021 at 2 PM. WSHA will continue to monitor this rulemaking and provide updates. (David Streeter)

Notifiable Conditions– The Washington State Board of Health issued a new notifiable conditions CR 102 proposal for chapter 246-101 WAC. The current rules contain the list of conditions and data that hospitals, health care providers, laboratories, and other entities must report to public health authorities when patients present with the specified health issues. The proposed rules make significant changes to the chapter, which has not been updated since 2011. According to the CR 102, the changes will “better protect public health by improving our understanding of emerging conditions, allowing more thorough case investigations, and improving the public health response to infectious and noninfectious conditions.” WSHA will review the proposal and taking appropriate action. Comments are due to the board by February 26, 2021 and can be submitted through the Department of Health’s comment webpage or via email to The board will also hold a virtual public hearing on the proposal on March 10, 2021. Registration for the hearing is available here. Please visit the board’s notifiable conditions rulemaking for more information. (David Streeter)

Click here to see WSHA’s Top Priority State Rules Tracker – **2021 Completed Rules**

Click here to see WSHA’s Top Priority State Rules Tracker – **2020 Completed Rules**

Click here to see WSHA’s Top Priority State Rules Tracker – **2019 Completed Rules**

Click here to see WSHA’s Top Priority State Rules Tracker – **2018 Completed Rules**


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