PREPROPOSAL STATEMENT OF INQUIRY
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Subject of Possible Rule Making: New sections in chapter 388-550 WAC, Hospital services.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 74.08.090.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: In order to improve the area of outpatient hospital expenditures, the department has elected to implement a new Medicaid payment method for outpatient hospital services provided to Medicaid clients. The outpatient prospective payment system (OPPS) uses claims and cost data to calculate payments for outpatient hospital services provided to eligible medical assistance clients. OPPS is expected to provide consistency for providers when billing for outpatient hospital services that are reimbursed by state agencies.
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) and the Health Care Authority (HCA) have implemented OPPS. DSHS/MAA is developing rules that are consistent and equitable with the L&I and HCA OPPS.
Process for Developing New Rule: The department invites the interested public to review and provide input on the draft language of this proposed WAC amendment. Draft material and information about how to participate may be obtanied from the department representative listed 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, Rules Program Manager, P.O. Box 45533, Olympia, WA 98504-5533, phone (360) 725-1342, fax (360) 586-9727, e-mail sayrek@dshs.wa.gov, TDD 1-800-848-5429.
January 20, 2004
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit