WSR 24-11-113

HEALTH CARE AUTHORITY

[Filed May 20, 2024, 12:41 p.m.]

Title or Subject: Medicaid State Plan Amendment (SPA) 24-0034 DRG Updates.

Effective Date: July 1, 2024.

Description: The health care authority (HCA) intends to submit SPA 24-0034 to remove outdated payment methodology for diagnosis-related group (DRG) hospital payments, remove the reference to a specific version of the all patient refined diagnosis-related group (APR-DRG) classification software, replace references to "chemical" use with "substance" use, and add a definition for medically necessary gender affirming care.

SPA 24-0034 is expected to have no effect on annual aggregate payment/reimbursement/expenditures, as it is primarily a "housekeeping" action.

SPA 24-0034 is under development. HCA would appreciate any input or concerns regarding this SPA. To request a copy when it becomes available or submit comments, please contact the person named below by June 18, 2024 (please note that all comments are subject to public review and disclosure, as are the names of those who comment).

CONTACT: Abigail Cole, Hospital Finance, 626 8th Avenue S.E., Olympia, WA 98504, phone 360-725-1835, TRS 711, email abby.cole@hca.wa.gov.