S-849                 _______________________________________________

                                                   SENATE BILL NO. 4124

                        _______________________________________________

State of Washington                              49th Legislature                              1985 Regular Session

By Senators Moore and Johnson

Read first time 2/8/85 and referred to Committee on Human Services and Corrections.

AN ACT Relating to reimbursement for medical care; and amending RCW 74.46.440 and 74.46.460.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

        Sec. 1.  Section 44, chapter 177, Laws of 1980 and RCW74.46.440 are each amended to read as follows:

          Only those services which are authorized for a facility pursuant to the medical care program shall be reimbursed under this chapter.  However, those licensed nursing homes that are serving the developmentally disabled under contract with the division of developmental disabilities shall be reimbursed under this chapter for those services required to be performed under the contract.

        Sec. 2.  Section 46, chapter 177, Laws of 1980 as last amended by section 21, chapter 67, Laws of 1983 1st ex. sess. and RCW 74.46.460 are each amended to read as follows:

          (1) Each contractor's reimbursement rates will be determined prospectively at least once each calendar year, to be effective July 1st.

          (2) Rates may be adjusted as determined by the department to take into account variations of more than ten percent in the distribution of patient classifications or changes in patient characteristics from the prior reporting year, program changes, changes in staffing levels at a facility required by the department, economic trends and conditions, and/or administrative review provided by RCW 74.46.780 and shall be adjusted for any capitalized additions or replacements made as a condition for licensure or certification.

          (3) Rates of those licensed nursing homes serving the developmentally disabled under contract with the division of developmental disabilities shall be adjusted to take into account maintenance costs that are a result of the damage or abnormal wear and tear associated with the clients served by those facilities.

(4) Where the contractor participated in the provisions of prospective cost-related reimbursement in effect prior to July 1, 1983, such contractor's prospective rate effective July 1, 1983, will be determined utilizing the contractor's desk-reviewed allowable costs for calendar year 1982.

          (((4))) (5) All prospective reimbursement rates for 1984 and thereafter shall be determined utilizing the prior year's desk-reviewed cost reports.