WSR 99-12-071



(Medical Assistance Administration)

[ Filed May 27, 1999, 2:09 p.m. ]

Subject of Possible Rule Making: WAC 388-550-6000 Payment--Outpatient hospital services, and related sections.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 74.08.090, 42 U.S.C. 1320B-5.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: In order to improve the area of outpatient expenditures, the department has elected to implement a new Medicaid payment method for outpatient services provided to Medicaid clients. The new method is the outpatient prospective payment system (OPPS). OPPS will allow better management of outpatient expenditures and related data. Since the payment calculation process in the new OPPS is significantly different from the current reimbursement system, the current rules need to be amended to allow the department to make the necessary changes.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The Department of Labor and Industries (L&I) is also developing rules to implement OPPS. The Health Care Authority (HCA) is implementing OPPS as well. Therefore, DSHS/MAA is working in coordination with L&I and HCA to develop rules that are consistent and equitable.

Process for Developing New Rule: In order to be consistent with the Governor's Executive Order 97-02, several agencies are coordinating rule development efforts; DSHS/MAA is working with L&I and HCA through the Interagency Work Group. External stakeholders will be involved through the existing outpatient prospective payment system Technical Advisory Group (OPPS-TAG). The department also invites the interested public to review and provide input on the draft language of this WAC. Draft material and information about how to participate are available by contacting the DSHS representative identified below.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kathy Sayre, Program Assistance and Support Services, Medical Assistance Administration, Olympia, WA 98504-5530, fax (360) 753-7315, TTY 1-800-848-5429, e-mail

May 25, 1999

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit

Washington State Code Reviser's Office