WSR 22-10-033
HEALTH CARE AUTHORITY
[Filed April 26, 2022, 5:39 p.m.]
NOTICE
Title or Subject: Medicaid State Plan Amendment (SPA) 21-0018 Sole Community Hospital Enhancement Rates—Inpatient.
Effective Date: July 1, 2022.
The health care authority (HCA) intends to submit Medicaid SPA 22-0018 because the Washington state legislature recently passed ESSB 5693 directing HCA to implement changes to payments to hospitals meeting the following criteria:
(a) Must be certified by the Centers for Medicare and Medicaid Services as sole community hospitals as of January 1, 2013;
(b) Must have had less than 150 acute care licensed beds in fiscal year 2011;
(c) Must have a Level III Adult Trauma Service designation from the department of health as of January 1, 2014;
(d) Must be owned and operated by the state or a political subdivision; and
(e) Not participate in the certified public expenditures payment program defined in WAC 182-550-4650.
SPA 22-0018 is expected to have no effect on the annual aggregate expenditures/reimbursements as compared to prior years.
ESSB 5693 increases the rates for sole community hospital inpatient rate enhancements as shown in the table below. In addition to implementing ESSB 5693, SPA 22-0018 simplifies the information currently in the state plan by replacing narrative with an easier-to-understand table as shown below.
Enhancement Multipliers
Hospital category
Effective Dates
July 1, 2015 -
June 30, 2020
July 1, 2020 -
June 30, 2021
July 1, 2021 -
June 30, 2022
July 1, 2022 -
June 30, 2023
Sole Community Hospital
1.25
1.5
N/A
1.25
Sole Community Hospital accepting single-bed certification per RCW 71.05.745 as of July 1, 2021.
N/A
N/A
1.5
1.5
HCA is in the process of completing the draft SPA. A copy of the draft SPA will be provided on request as soon as it becomes available. Please contact the person named below (please note that all comments are subject to public review and disclosure, as are the names of those who comment).
Contact: Melissa Craig, Inpatient Program Manager, 626 8th Avenue S.E., Olympia, WA 98501, telecommunications relay service 711, email Melissa.craig@hca.wa.gov.