he federal Office of the Inspector General (OIG) recently released results of two separate audits where they claimed the Washington State Medicaid program made improper payments. In one audit, OIG claimed the state made $9.2 million in improper electronic health record incentive payments.... Read More >>

When the Washington State Health Care Authority rebased inpatient and outpatient rates in July 2014, they originally suggested a three percent cut to adjust for coding changes in the new system. WSHA and our hospitals pushed back and HCA agreed to measure changes for a two-year period, making budget neutrality adjustments as needed.... Read More >>

The Hospital Safety Net Assessment Program for State Fiscal 2017 went into effect July 1, 2016. Under the program, the state collects assessments from hospitals.... Read More >>

WSHA submitted a comment letter in response to the Health Care Authority’s proposed changes to the payment rules governing Medicaid payment to federally qualified health centers (FQHCs) and rural health clinics. In our letter, WSHA voices concerns that the proposed rule language does not enable clinics to support transformation of care delivery without taking on significant financial risk of reduced payments.... Read More >>

Despite strong interest from WSHA, WSMA and members of the two organizations, the Bree Collaborative voted last week to not address prior authorization as a major focus area for the upcoming year.... Read More >>

On September 23, the Office of the Insurance Commissioner (OIC) released a third iteration of stakeholder draft rules concerning prior authorizations. We are pleased that the OIC has undertaken a rule making process on prior authorization and is trying to provide more transparency around some of the requirements.... Read More >>

Starting February 1, 2017, all Medicaid contracted hospitals and providers will be required to participate in Washington’s new clinical data sharing program, called Link4Health. Link4Health is a Health Care Authority (HCA) initiative that will require providers who care for Medicaid patients to share certain clinical records electronically with HCA via a clinical data repository.... Read More >>

WSHA is in the process of preparing materials to help member hospitals meet federal observation notification requirements.... Read More >>

Many hospitals are struggling with significant numbers of patients who have completed their acute hospital stay, but for whom post-hospital placement cannot be found. This ties up acute care beds in hospitals that are already running at or near capacity. ... Read More >>

The Washington Health Care Authority (HCA) recently released proposed changes to the payment rules governing Medicaid payment to federally qualified health centers (FQHCs) and rural health clinics. The changes are intended to accommodate a new alternative payment model (APM) which HCA plans to pilot with a group of interested clinics effective January 1, 2017. ... Read More >>