WSR 16-10-087

[Filed May 3, 2016, 2:01 p.m.]

Title or Subject: Medicaid State Plan Amendment (SPA) 16-0013 Outpatient Prospective Payment System (OPPS) Updates.

Effective Date: July 1, 2016.

Description: The health care authority (HCA) intends to submit medicaid SPA 16-0013 to reflect periodic changes related to paying hospital outpatient facilities. The updates include changes to the outpatient fee schedule, changes to the hospital conversion factors, changes in EAPG weights, and a changed EAPG grouper. All of these changes are budget neutral. HCA constrains its total payments to a set level via a budget neutrality factor as part of the payment calculations. The fee schedule and conversion factor changes are regularly occurring periodic changes due to new or changed codes and cost report data. The weights and grouper changes are to maintain currency with 3M software changes.

SPA 16-0013 is anticipated to have no effect on annual aggregate expenditures.

The SPA is in the development process; therefore a copy is not yet available for review. To contact the agency for additional information and a copy of the SPA when it becomes available, please contact Jean Bui, Office of Professional and Hospital Rates, P.O. Box 45502, Olympia, WA 98504, phone (360) 725-1973, TYY/TDD [TTY/TDD] 1-800-848-5429, e-mail jean.bui@hca.wa.gov.