WSR 24-19-090
PROPOSED RULES
HEALTH CARE AUTHORITY
[Filed September 17, 2024, 12:17 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 24-15-117.
Title of Rule and Other Identifying Information: WAC 182-550-5130 Payment method—Institution for mental diseases disproportionate share hospital (IMDDSH) and institution for mental diseases (IMD) state grants, 182-550-5210 Payment method—Small rural indigent assistance disproportionate share hospital (SRIADSH), 182-550-5220 Payment method—Nonrural indigent assistance disproportionate share hospital (NRIADSH), and 182-550-5380 Payment method—Sole community disproportionate share hospital (SCDSH).
Hearing Location(s): On October 22, 2024, at 10:00 a.m. The health care authority (HCA) holds public hearings virtually without a physical meeting place. To attend the virtual public hearing, you must register in advance https://us02web.zoom.us/webinar/register/WN_icWpKqAQTxyCXgTcltuVgA. If the link above opens with an error message, please try using a different browser. After registering, you will receive a confirmation email containing information about joining the public hearing.
Date of Intended Adoption: Not sooner than October 23, 2024.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email arc@hca.wa.gov, fax 360-586-9727, beginning September 18, 2024, 8:00 a.m., by October 22, 2024, by 11:59 p.m.
Assistance for Persons with Disabilities: Contact Johanna Larson, phone 360-725-1349, fax 360-586-9727, telecommunication relay service 711, email Johanna.Larson@hca.wa.gov, by October 4, 2024.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: HCA is amending WAC 182-550-5130 to remove subsections (5) and (6). HCA does not distribute any state funded grants for IMDDSH; there is no state money allocated to IMD. HCA is repealing WAC 182-550-5210, 182-550-5220, and 182-550-5380; old information, the programs have not been funded by the legislature for over 10 years.
Reasons Supporting Proposal: See purpose.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Valerie Freudenstein, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1344; Implementation and Enforcement: Mary O'Hare, P.O. Box 42716, Olympia, WA 98504, 360-725-9820.
A school district fiscal impact statement is not required under RCW
28A.305.135.
A cost-benefit analysis is not required under RCW
34.05.328. RCW
34.05.328 does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.
This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:
Scope of exemption for rule proposal:
Is fully exempt.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. These are changes to hospital rules; does not affect small businesses.
September 17, 2024
Wendy Barcus
Rules Coordinator
OTS-5665.1
AMENDATORY SECTION(Amending WSR 15-18-065, filed 8/27/15, effective 9/27/15)
WAC 182-550-5130Payment method—Institution for mental diseases disproportionate share hospital (IMDDSH) and institution for mental diseases (IMD) state grants.
(1) A psychiatric hospital owned and operated by the state of Washington is eligible to receive payments under the institution for mental diseases disproportionate share hospital (IMDDSH) program.
(2) For the purposes of the IMDDSH program, the following definitions apply:
(a) "Institution for mental diseases (IMD)" means a hospital, nursing facility, or other institution of more than ((sixteen))16 beds, that is primarily engaged in providing diagnosis, treatment, or care of people with mental diseases, including medical attention, nursing care, and related services.
(b) "Psychiatric community hospital" means a psychiatric hospital other than a state-owned and operated hospital.
(c) "Psychiatric hospital" means an institution which is primarily engaged in providing psychiatric services for the diagnosis and treatment of mentally ill people. The term applies to a medicare-certified distinct psychiatric care unit, a medicare-certified psychiatric hospital, or a state-designated pediatric distinct psychiatric unit in a medicare-certified acute care hospital.
(d) "State-owned and operated psychiatric hospital" means eastern state hospital and western state hospital.
(3) Except as provided in subsection (4) of this section, a psychiatric community hospital, regardless of location, is not eligible to receive:
(a) IMDDSH payments; or
(b) Any other disproportionate share hospital (DSH) payment from the medicaid agency. See WAC 182-550-4800 regarding payment for psychiatric claims for clients eligible under the medical care services programs.
(4) A psychiatric community hospital within the state of Washington that is designated by the agency as an IMD is eligible to receive IMDDSH payment if:
(a) IMDDSH funds remain available after the amounts appropriated for state-owned and operated psychiatric hospitals are exhausted; and
(b) The legislature provides funds specifically for this purpose.
(5) ((A psychiatric community hospital within the state of Washington that is designated by the agency as an IMD is eligible to receive a state grant amount from the agency if the legislature appropriates funds specifically for this purpose.
(6) An institution for mental diseases located out-of-state, including an IMD located in a designated bordering city, is not eligible to receive a Washington state grant amount.
(7))) Under federal law, 42 U.S.C. 1396r-4 (h)(2), the state's annual IMDDSH expenditures are capped at ((thirty-three))33 percent of the state's annual statewide DSH cap. This amount represents the maximum that the state can spend in any given fiscal year on IMDDSH, but the state is under no obligation to actually spend that amount.
REPEALER
The following sections of the Washington Administrative Code are repealed:
WAC 182-550-5210 | Payment method—Small rural indigent assistance disproportionate share hospital (SRIADSH). |
WAC 182-550-5220 | Payment method—Nonrural indigent assistance disproportionate share hospital (NRIADSH). |
WAC 182-550-5380 | Payment method—Sole community disproportionate share hospital (SCDSH). |