[atlas:bill]

AN ACT Relating to maintenance of low-income disproportionate share hospital payments; amending 1999 c 309 s 210 (uncodified); making appropriations; providing an effective date; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1) 1999 c 309 s 210 (uncodified) is amended to read as follows:

FOR THE DEPARTMENT OF SOCIAL AND HEALTH SERVICES‑-MEDICAL ASSISTANCE PROGRAM

General Fund‑-State Appropriation (FY 2000).... $ 722,863,000

General Fund‑-State Appropriation (FY 2001).... $ 784,657,000

General Fund‑-Federal Appropriation............. $.................................. ((~~2,345,803,000~~))

2,401,804,000

General Fund‑-Private/Local Appropriation...... $ 261,534,000

Emergency Medical Services and Trauma Care Systems

Trust Account‑-State Appropriation......... $ 9,200,000

Health Services Account‑-State Appropriation... $ ((~~339,535,000~~))

397,982,000

TOTAL APPROPRIATION................. $ ((~~4,463,592,000~~))

4,578,040,000

The appropriations in this section are subject to the following conditions and limitations:

(1) The department shall continue to make use of the special eligibility category created for children through age 18 and in households with incomes below 200 percent of the federal poverty level made eligible for medicaid as of July 1, 1994.

(2) It is the intent of the legislature that Harborview medical center continue to be an economically viable component of the health care system and that the state's financial interest in Harborview medical center be recognized.

(3) Funding is provided in this section for the adult dental program for Title XIX categorically eligible and medically needy persons and to provide foot care services by podiatric physicians and surgeons.

(4) $1,647,000 of the general fund‑-state appropriation for fiscal year 2000 and $1,672,000 of the general fund‑-state appropriation for fiscal year 2001 are provided for treatment of low-income kidney dialysis patients.

(5) $80,000 of the general fund‑-state appropriation for fiscal year 2000, $80,000 of the general fund‑-state appropriation for fiscal year 2001, and $160,000 of the general fund‑-federal appropriation are provided solely for the prenatal triage clearinghouse to provide access and outreach to reduce infant mortality.

(6) ((The department shall adopt a new formula for distributing funds under the low-income disproportionate share hospital (LI-DSH) program. Under this new formula, (a) the state's Level 1 trauma center shall continue to receive the same amount of LI-DSH payments as in fiscal year 1999; and (b) a net profitability factor shall be included with other factors to determine LI-DSH payments. The net profitability factor shall inversely relate hospital percent net operating income to payment under the program.)) $6,400,000 of the health services account appropriation is provided solely to replace general fund‑-state and general fund‑-federal funding so that the current level of payments to hospitals under the low-income disproportionate share hospital program can be maintained, under the current low-income disproportionate share hospital payment distribution methodology.

(7) The department shall report to the fiscal committees of the legislature by September 15, 1999, and again by December 15, 1999, on (a) actions it has taken and proposes to take to increase the share of medicare part B premium payments upon which it is collecting medicaid matching funds; (b) the percentage of such premium payments for each month of service subsequent to June 1998 which have been paid with unmatched, state-only funds; and (c) why matching funds could not be collected on those payments.

(8) The department shall report to the fiscal committees of the legislature by December 1, 1999, and again by October 1, 2000, on the amount which has been recovered from third-party payers as a result of its efforts to improve coordination of benefits on behalf of "basic health plan-plus" enrollees.

(9) The department shall report to the health care and fiscal committees of the legislature by December 1, 1999, on options for controlling the growth in medicaid prescription drug expenditures through strategies such as but not limited to volume purchasing, selective contracting, supplemental drug discounts, and improved care coordination for high utilizers.

(10) $3,992,000 of the health services account appropriation and $7,651,000 of the general fund‑-federal appropriation are provided solely for health insurance coverage for children with family incomes between 200 percent and 250 percent of the federal poverty level, as provided in Substitute Senate Bill No. 5416 (children's health insurance program). If the bill is not enacted by June 30, 1999, these amounts shall lapse.

(11) $191,000 of the general fund‑-state appropriation for fiscal year 2000 and $391,000 of the general fund‑-state appropriation for fiscal year 2001 are provided solely for implementation of Substitute Senate Bill No. 5587 (patient bill of rights). If the bill is not enacted by June 30, 1999, these amounts shall lapse.

(12) Upon approval from the federal health care financing administration, the department shall implement the section 1115 family planning waiver to provide family planning services to persons with family incomes at or below two hundred percent of the federal poverty level.

(13) Except in the case of rural hospitals and Harborview medical center, weighted average payments under the ratio-of-cost-to-charges hospital payment system shall increase by no more than 175 percent of the DRI HCFA hospital reimbursement market basket index.

(14) In accordance with Substitute Senate Bill No. 5968, $52,047,000 of the health services account appropriation and $56,002,000 of the general fund--federal appropriation, or so much thereof as may be expended without exceeding the medicare upper payment limit, are provided solely for supplemental payments to nursing homes operated by rural public hospital districts. Such payments shall be distributed among the participating rural public hospital districts proportional to the number of days of medicaid-funded nursing home care provided by each district during the preceding calendar year, relative to the total number of such days of care provided by all participating rural public hospital districts. Prior to making any supplemental payments, the department shall first obtain federal approval for such payments under the medicaid state plan. The payments shall further be conditioned upon (a) a contractual commitment by the association of public hospital districts and participating rural public hospital districts to make an intergovernmental transfer to the state treasurer, for deposit into the health services account, equal to at least 82 percent of the supplemental payment amount; and (b) a contractual commitment by the participating districts to not allow expenditures covered by the supplemental payments to be used for medicaid nursing home rate-setting.

NEW SECTION. Sec. 2) This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 1, 1999.