News

The Pharmacy Commission wants to hear from you. The commission is seeking feedback from license holders regarding the pharmacy license inspection process through its online customer satisfaction survey, which is voluntary and anonymous.... Read More >>

The legislative session started on Monday, and if anyone had any lingering holiday dust, it’s been shaken off now. New committee chairs are in place and committee hearings have begun. After last year’s record-breaking long session, one of the hot topics is whether this year’s session will end on time. Everyone may be agreed on that intention, but the legislature has significant challenges ahead — especially around the McCleary decision on school funding and Initiative 1366.... Read More >>

Cassie Sauer, Claudia Sanders and Mary Kay Clunies-Ross talked about WSHA’s top priorities for the session, as well as how recent leadership changes might affect health care legislation this year.... Read More >>

The purpose of this bulletin is to inform Prospective Payment System (PPS) hospitals of changes to their Medicaid inpatient hospital payment rates effective January 1, 2016 due to changes to the Health Care Authority’s policy on paying for readmissions. HCA is replacing its existing policy of reviewing and denying individual readmission claims with a policy that uses a software program to compare each hospital’s rate of potentially preventable readmissions (PPR) rate with an expected rate based on the state’s general experience and the hospital’s mix of cases. Hospitals with higher than expected potentially preventable readmissions are subject to a penalty reduction applied to their inpatient payment rate.... Read More >>

WSHA is continuing to work the Washington State Health Care Authority (HCA) on an error the HCA made in calculations when making a budget neutrality adjustment in November. The HCA made an 8 percent reduction in inpatient Medicaid rates for prospective payment hospitals; WSHA questioned the validity of the change. WSHA is working with the HCA and encouraging them to make appropriate corrections for the next adjustment period, which starts Feb. 1.... Read More >>

The 2016 legislative session is now underway, and this year’s session is slated to be a short one. This year, a supplemental budget year, our top budget priority is mental health, which Governor Jay Inslee also identified as a major need in his December supplemental budget. We are hoping to continue the gains in mental health funding that began last year.... Read More >>

The Health Care Authority has revised both its inpatient hospital and physician-related services provider billing guides to reflect changes to its policy regarding payment for elective early deliveries. Effective January 1, 2016, HCA will not pay for professional or hospital charges related to elective early deliveries before 39 weeks gestation, unless the physician documents that the early delivery is medically necessary. ... Read More >>

Under a federal law passed last summer, hospitals may need to provide written and oral notification to Medicare patients placed in observation status as early as August 2016. Unfortunately, the federal rulemaking process may leave little time for hospitals to implement the requirements once the specific requirements are known. The Centers for Medicare and Medicaid Services (CMS) has not yet released its proposed rule for comment.... Read More >>

The Health Care Authority has extended its deadline to February 1 for providers to apply to offer total joint replacements using bundled payments for its coverage for state employees. The proposal, based on the episode of care established by the Bree Collaborative, includes establishment of patient disability and failure of more conservative treatment, determination of fitness for surgery, use of evidence-based surgical practices, and standardized post-operative care.... Read More >>

Medicaid inpatient hospital payment rates for Washington hospitals paid on the prospective payment system now incorporate penalties based on “excessive” rates of hospital readmissions. A number of hospitals will see small reductions in payment because of this change – with penalties ranging from 0.0 percent to a maximum of 1.0 percent. The new policy from the Health Care Authority penalizes hospitals that appear to have an excessive number of potentially preventable admissions, based on an HCA analysis using 3M Corporation software.... Read More >>