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: January 8, 2019)

There are several important regulatory issues at the top of WSHA’s priority list:

  1. Charity Care.We are actively engaged in the Department of Health’s charity care rulemaking. The next rules development workshop will be held on Feb. 19, 2019 at 1:00 p. At that meeting, the workgroup will discuss revised proposals from DOH and stakeholders. DOH’s next proposals will be distributed around Jan. 31, 2019. Stakeholder proposals are due by Feb. 11, 2019, and will be distributed Feb. 12, 2019, in advance of the workshop. Further details, including workshop location and web conferencing information, is available on the Charity Care Rules website. (Zosia Stanley)
  2. Opioid Prescribing. We continue to closely follow the efforts of the various Boards and Commissions of the Department of Health to revise their respective rules regarding opioid prescribing, pursuant to ESHB 1427 (2017). The Nursing Care Quality Assurance Commission (NCQAC) rules went into effect on Nov. 1, 2018 (available here). The Medical Quality Assurance Commission (MQAC) rules went into effect on Jan. 1, 2019 (available here). The Dental Quality Assurance Commission (DQAC) will go into effect on Jan. 26, 2019 (available here). Toolkits for providers regarding opioid prescribing are available here. (Ian Corbridge)
  3. EMS and Trauma Care.We are closely following the ongoing stakeholder meetings related to revising rules governing emergency medical services (EMS) and trauma care. The next stakeholder meeting has been *re-scheduled to January 24, 2019* at 9:30. There has also been a room change: DOH Town Center 2 Room 145 111 Israel Road SE Tumwater, Washington 98501. Further information, including web conferencing information is available on the EMS rulemaking website. (Lauren McDonald)
  4. Overtime for Exempt Employees.We are also closely following the rulemaking process about overtime pay exemptions for Executive, Administrative and Professional (EAP) workers by the Department of Labor and Industries. We recently commented with concerns about the second pre-draft rules by L&I.  The formal proposal and commencement of the official rulemaking process is expected to commence in early 2019.  (Jaclyn Greenberg)

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**

(Updated: Jan. 8, 2019)

In addition to our 2018 year end list of completed rules impacting hospitals and health systems, we are including a running list of rulemaking completed in 2019. Each completed rules list contains our quick take of the result. Look for the thumbs up, thumbs down or neutral marker.

HCA Rules Changes to Home Health Services and Medical Equipment Prescriptions

Effective Jan. 1, 2019, only physicians will be authorized to order home health services and medical equipment. The Health Care Authority amended its rules for home health services and durable medical equipment to align with federal regulations published by the Centers for Medicare and Medicaid Services (CMS) on Feb. 2, 2016. The federal rules are available here, and the HCA’s rules regarding durable medical equipment are available here, and regarding home health services here. A letter from the Medicaid Director at HCA is available here. (Jaclyn Greenberg)

Nursing and Medical Commissions: Upcoming Stakeholder and Rulemaking Workshops

(Update: Dec. 17, 2018)

Members may be interested in the following workshop meetings taking place in Jan. 2019:

  1. The Nursing Care Quality Assurance Commission (NCQAC) will be holding a series of workshops with interested stakeholders to discuss rules:
    • Relating to nursing scope of practice for licensed practical nurses, registered nurses and advanced registered nurse practitioners on Jan. 22, 23, and 24, 2019. The rulemaking filing is available here. More information about the time and location of the meetings, as well as dial-in information is available here.
    • Relating to nursing continuing competency requirements for active, inactive, expired and retired active credential status on Jan. 22, 23 and 24, 2019. The rulemaking filing is available here. More information about the time and location of the meetings, as well as dial-in information is available here.
  2. The Medical Quality Assurance Commission (MQAC) will be holding two rule workshops on Jan. 16, 2019:
    • Relating to a Clinical Support Program that would assist practitioners with practice deficiencies and establish continuing competency mechanisms. Further details are available here.
    • Relating to MQAC’s governing regulations, particularly with respect to rules language for physicians and ensuring the regulations are updated and modernizes to align with current national industry and best practice standards. Further details are available here.

Hospital Construction Standards Rules Project

Members may also want to note that the Department of Health is reviewing certain rules governing hospital construction standards. DOH is in the early stages of that process, namely reviewing draft rules language and proposals at workshops. The workshops took place in October and early December 2018. Meeting notes from the second workshop are expected soon. The formal proposal (a filed CR-102) is expected Spring 2019.

Full details, including the draft rules language, a link to a webinar on the 2018 Facility Guideline Institute (FGI) changes (on which the revised rules will be based), and a report on draft proposals are available here.

Please contact DOH Construction Review Services Manager John Williams to receive free access to the 2018 FGI Guidelines.

Find more general information on this rulemaking on the Construction Review Services website or by joining the Construction Review listserv.

Please contact us if there is a state rulemaking activity impacting your hospital or health system that you do not see listed here. (Jaclyn Greenberg)


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