Date of Adoption: June 30, 1999.

Purpose: To clarify terms and add previously undefined terms.

Citation of Existing Rules Affected by this Order: Amending WAC 388-550-1050 Hospital definitions.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.730, 42 U.S.C. 1395x(v), 42 C.F.R. 447.271, .11303 and .2652.

Adopted under notice filed as WSR 99-09-088 on April 21, 1999.

Changes Other than Editing from Proposed to Adopted Version: 1) Definition for "Inflation adjustment" changed from: "...means, for cost inflation, the hospital inflation ((factor determined by Data Resources, Inc., (DRI) and published in the DRI/McGraw Hill Report. See also "hospital market basket index.")) adjustment. This adjustment is the vendor rate increase identified by the legislature as the adjustment to be applied to payment rates used to reimburse vendors, including health care providers, that provide services to the state. If the legislature does not identify an inflation adjustment for the vendor rates for a given period, then there is no inflation adjustment for that period."

To: "...means, for cost inflation, the hospital inflation ((factor determined by Data Resources, Inc., (DRI) and published in the DRI/McGraw Hill Report. See also "hospital market basket index.")) adjustment. This adjustment is determined by using the inflation factor method and guidance indicated by the legislature in the budget notes to the biennium appropriations bill."

2) Definition for "Profitability factor" changed from: "...means a factor used to calculate a hospital's low income disproportionate share (LIDSH) payment. The methods used to determine the profitability factor are:

(1) Determine the net revenue of each LIDSH qualified hospital. The net revenue will be the "net revenue" figure identified on the MAA hospital disproportionate share application submitted by the hospital;..."

To: "...means a factor used to calculate a hospital's low income disproportionate share (LIDSH) payment. The methods used to determine the profitability factor are:

(1) Determine the net revenue of each LIDSH qualified hospital. The net revenue will be the "net revenue" figure identified on the MAA hospital disproportionate share application submitted by the hospital. (Net revenue may be calculated using a three year average net revenue using "net revenue" figures from the most recent three years' MAA hospital disproportionate share applications."

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 1, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.

Other Findings Required by Other Provisions of Law as Precondition to Adoption or Effectiveness of Rule: Per RCW 34.05.380(3), the rule must become effective July 1, 1999, because SHB 5968 and the budget notes clarifying the senate budget bill (ESSB 5180) contain hospital definitions and mandate this effective date.Effective Date of Rule: July 1, 1999.

June 30, 1999

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit

Reviser's note: The material contained in this filing exceeded the page-count limitations of WAC 1-21-040 for appearance in this issue of the Register. It will appear in the 99-15 issue of the Register.

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