HOUSE BILL REPORT
SHB 1635
This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent. |
As Passed House:
February 14, 2014
Title: An act relating to disproportionate share hospital adjustments.
Brief Description: Concerning disproportionate share hospital adjustments.
Sponsors: House Committee on Appropriations (originally sponsored by Representatives Morrell, Cody, Jinkins, Ryu and Pollet; by request of Health Care Authority).
Brief History:
Committee Activity:
Appropriations: 2/11/13, 2/13/13 [DPS], 1/21/14 [DP].
Floor Activity:
Passed House: 3/5/13, 96-0.
Floor Activity:
Passed House: 2/14/14, 96-0.
Brief Summary of Substitute Bill |
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HOUSE COMMITTEE ON APPROPRIATIONS |
Majority Report: Do pass. Signed by 31 members: Representatives Hunter, Chair; Ormsby, Vice Chair; Chandler, Ranking Minority Member; Ross, Assistant Ranking Minority Member; Wilcox, Assistant Ranking Minority Member; Buys, Carlyle, Christian, Cody, Dahlquist, Dunshee, Fagan, Green, Haigh, Haler, Harris, Hudgins, G. Hunt, S. Hunt, Jinkins, Kagi, Lytton, Morrell, Parker, Pettigrew, Schmick, Seaquist, Springer, Sullivan, Taylor and Tharinger.
Staff: Erik Cornellier (786-7116).
Background:
Medical assistance is available to eligible low-income state residents and their families from the Health Care Authority (HCA), primarily through the Medicaid program. Most of the state medical assistance programs are funded with federal matching funds in various percentages.
The federal government matches state funding for Disproportionate Share Hospitals (DSH), which are hospitals that serve a disproportionate share of Medicaid clients or the uninsured. States make DSH payments directly to hospitals, and the federal government reimburses them for part of the payments based on each state's Medicaid matching rate. States receive a DSH allotment that sets an upper limit on how much federal Medicaid money they can spend on DSH payments.
The DSH program offers flexibility to states in how they distribute DSH funds. States are required to take into account the situation of hospitals which serve a disproportionate number of low-income patients with special needs.
To the extent that funds are appropriated specifically for these purposes, the HCA must provide DSH payments considering low-income care and medical indigency components and a state-only component for hospitals that do not qualify for federal payments.
The low-income component must be based on a hospital's Medicaid utilization rate, its low-income utilization rate, its provision of obstetric services, and other factors authorized by federal law.
The Medically Indigent program expired in 2003, and the calculation of the medical indigency care component was eliminated.
Funding for the state-only component was eliminated in the 2009-11 State Omnibus Operating Appropriations Act.
Summary of Substitute Bill:
The requirements for the low-income component of the DSH payments are reduced to consideration of the situation of hospitals serving a disproportionate number of low-income patients with special needs and compliance with federal requirements.
The medical indigency and state-only components of the DSH payments are removed.
The HCA's expenditures on DSH payments may not exceed the federal DSH allotment.
The HCA may create DSH payment mechanisms in addition to the low-income component if sufficient funds are specifically appropriated for that purpose.
The Director of the HCA may adopt rules to implement these provisions.
Appropriation: None.
Fiscal Note: Available on original bill.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.
Staff Summary of Public Testimony:
See House Bill Report in the 2013 Regular Session.
Persons Testifying: See House Bill Report in the 2013 Regular Session.
Persons Signed In To Testify But Not Testifying: See House Bill Report in the 2013 Regular Session.