CMS Announces Recovery Audit Contractor Program Improvements

After several years of frustration and advocacy, hospitals should soon see meaningful reform to the Recover Audit Contractor (RAC) program. Effective January 1, the amount of audit requests RACs will be able to request for a hospital will be reduced by three-fourths, from 2.0 percent down to 0.5 percent of the hospital’s paid Medicare claims from the previous year.... Read More >>

WSHA Provides Rate Appeals Guidance and Webinar Slides for November 1 Medicaid Cuts

The Health Care Authority recently sent Prospective Payment System (PPS) hospitals notices of new Medicaid inpatient and outpatient payment rates, effective November 1. These changes are due to state calculations to ensure budget neutrality. ... Read More >>

WSHA to Help Represent Clinic Interests in Payment Redesign

The Washington State Health Care Authority (HCA) is beginning the process of updating the Medicaid payment methodology for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics. HCA is in the final stages of contracting with a technical assistance consultant to work with stakeholders to develop a successor to the current alternative payment methodology (APM).... Read More >>

CMS Implements Bundled Payments for Hip and Knee Replacements; WSHA Provides Resources

On November 16, the Centers for Medicare & Medicaid Services (CMS) finalized its rule concerning payment of hip and knee replacements for hospitals in selected regions. The new program goes into effect April 1, 2016 and will affect hospitals in the Seattle-Tacoma-Bellevue and Portland-Vancouver-Hillsboro metropolitan service areas that provide hip and knee replacement surgery.... Read More >>

Standardized Financial Assistance Application and Communication Plan

This bulletin provides information on two financial assistance documents that WSHA will recommend every hospital adopt. WSHA intends to recommend that all hospitals adopt the standard financial assistance application and communication plan once these documents are finalized and approved by the WSHA Board. These documents focus on the patient-facing portions of the financial assistance process and do not dictate the levels of financial assistance offered at individual hospitals.... Read More >>

Sample Language for Appeal of Medicaid PPS Rates Effective November 1

The purpose of this bulletin is to provide Prospective Payment System (PPS) hospitals with information should they wish to appeal changes to their Medicaid hospital payment rates effective November 1. WSHA recommends they file a rate appeal with the Health Care Authority (HCA) within 60 days of the date of their rate notice to protect their right to a rate correction if it is determined the new rates are in error.... Read More >>

Hospital Financial Assistance Webinar

Important information on standard financial assistance application form and communication plan. WSHA will host a webinar on Monday, November 23, 2015 on the development of a standard financial assistance application form and standard financial assistance communication plan for Washington State hospitals. The webinar will include discussion of the impetus to develop standard documents, an overview of the workgroup process, and review of the draft application form and communication plan. ... Read More >>

L&I and stakeholders continue to discuss reasonable provisions on hospital equipment

The Washington State Department of Labor (L&I) and stakeholder groups continue to discuss modifying the Hazardous Drugs rules in WAC 296-62-500, Part R, to allow flexibility in provisions related to hospital equipment needed for the handling of hazardous drugs.... Read More >>

President signs two-year budget deal

The president Nov. 2 signed into law the Bipartisan Budget Act, P.L. 114-74, passed by Congress last week to raise the nation’s debt limit and set spending targets for the federal budget for the next two fiscal years. Site-neutral payments for new provider-based hospital outpatient departments are included in the legislation – a provision that was strongly opposed by the American Hospital Association (AHA) and WSHA.... Read More >>

Time for fall legislative visits

Now is the time for hospital and health system leaders to meet with members of the Washington State Legislature in advance of the 2016 legislative session, which begins Jan. 11, 2016. Most legislators highly value their own community hospitals and want to create policy that supports the efficient delivery of high-quality care.... Read More >>

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