WSR 15-07-045
PREPROPOSAL STATEMENT OF INQUIRY
HEALTH CARE AUTHORITY
(Washington Apple Health)
[Filed March 12, 2015, 10:46 a.m.]
Subject of Possible Rule Making: WAC 182-502-0160 Billing a client, 182-550-2900 Payment limitsInpatient hospital services, 182-533-0400 Maternity care and newborn delivery, 182-531-0150 Noncovered physician-related and health care professional servicesGeneral and administrative, and other rules as appropriate.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 41.05.021, 41.05.160.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The American College of Obstetricians and Gynecologists has consistently advised against nonmedically indicated elective deliveries prior to thirty-nine weeks gestation. These elective deliveries can increase the risk of significant complications for both the mother and the baby. Babies born in the thirty-seven - thirty-nine week range are likely to have less fully-developed brains, lungs and livers than those born after thirty-nine weeks. Some of these babies will require care in the neonatal intensive care unit which increases the cost of these deliveries. The Bree Collaborative recommends that no deliveries before thirty-nine weeks should occur; this WAC is intended to implement that recommendation.
The agency will no longer pay for elective deliveries before thirty-nine weeks of gestation, unless medically necessary, including inductions and cesarean sections.
During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy.
Process for Developing New Rule: The agency welcomes the public to take part in developing this rule. If interested, contact the person identified below to receive an early rule draft to review. After the early review, the agency will send a notice of proposed rule making (CR-102) to everyone receiving this notice and anyone who requests a copy.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Chantelle Diaz, P.O. Box 42716, Olympia, WA 98504-2716, fax (360) 586-9727, TTY 1-800-848-5429, e-mail Chantelle.Diaz@hca.wa.gov.
March 12, 2015
Jason R. P. Crabbe
Rules Coordinator