News

WSHA Provides Reports, Webinar on Medicare Joint Replacement Bundles

The Centers for Medicare and Medicaid Services (CMS) recently finalized its rule concerning the Comprehensive Care for Joint Replacement (CJR) program. The program will make hospitals that provide lower joint replacement surgeries in specified geographic areas financially responsible for costs related to an episode of care, including post-acute services. ... Read More >>

WSHA comments on draft balance billing legislation

On December 4, the Washington Office of the Insurance Commissioner (OIC) sent interested stakeholders, including WSHA, draft legislation concerning balance billing for services by a provider who is not contracted with a patient’s health plan, when the services are provided at a contracted hospital. ... Read More >>

Promote organ donations in your hospital

The Health Resources and Services Administration (HRSA) Division of Organ Donation and Transplant is encouraging hospitals to establish organ donor registration as a routine, especially among small and rural hospitals. HRSA is encouraging hospitals to participate in the giving spirit of the holiday season.... Read More >>

CAH Necessary Provider documentation needed for CMS survey

As a reminder, CMS requires all Critical Access Hospitals (CAHs) that are designated Necessary Providers (NPs) to provide documentation during their survey that proves the hospital received this designation from the state prior to 2006.... Read More >>

New HCA resources on Accountable Communities of Health: FAQ and conference calls

The state Health Care Authority (HCA) released a new Frequently Asked Questions document and announced monthly conference calls to answer questions and provide general updates on the Accountable Communities of Health (ACHs).... Read More >>

WSHA Provides Reports and Analyses of Medicare Outpatient Rule to Hospitals

On November 20, WSHA provided hospitals with an analysis of the Calendar Year 2016 Medicare outpatient prospective payment system final rule. WSHA also provided facility-specific impact reports to hospital Chief Financial Officers. The new payment rates include a 2.1 percent market basket increase that is offset by an ACA-mandated reduction of 0.7 percent and an additional adjustment reduction of 2 percent due to lab services that should have been bundled being paid separately in error. ... Read More >>

Insurance Commissioner Plans Balance Billing Legislation

Washington State Insurance Commissioner Mike Kreidler plans to submit proposed legislation in the upcoming 2016 session to limit balance billing of patients for out-of-network emergency services when a patient receives care at a facility contracted as in-network with their health plan.... Read More >>

HCA Incorporates WSHA Comments into Final Rule for Early Obstetrical Deliveries

The final rule for payment of early obstetrical deliveries adopted by the Washington State Health Care Authority (HCA) includes protections requested by WSHA for patients and providers. The rule is intended to deny Medicaid payment for early elective deliveries. The final rule allows payment for deliveries prior to 39 weeks if the early delivery is medically necessary.... Read More >>

Health Care Authority to Adjust November 1 Rate Cut for PPS Hospitals

On November 1, the Washington State Health Care Authority (HCA) reduced inpatient and outpatient hospital payments to prospective payment hospitals by 8 percent in order to apply budget neutrality adjustments due to the recent rebasing of the payment systems. In response to this significant change in Medicaid rates, WSHA requested HCA and its consultant, Navigant, review the calculations and provide WSHA with data sets to enable an independent analysis.... Read More >>

Mental health capital grants announced

Recognizing the continuing need for involuntary inpatient mental health services, the state Legislature funded $32 million in the 2015-2017 budget for capital grants to assist with construction or renovation for inpatient and crisis mental health services.... Read More >>

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