H-280                _______________________________________________

                                                     HOUSE BILL NO. 64

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State of Washington                              49th Legislature                              1985 Regular Session

By Representatives Wang, Ballard, Lewis, Day, Tanner, West, Gallagher, Fisch, Rayburn, Dobbs, Winsley and Barrett

Read first time 1/18/85 and referred to Committee on Social & Health Services.

AN ACT Relating to nursing home auditing; and amending RCW 74.46.460.

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

        Sec. 1.  Section 46, chapter 177, Laws of 1980 as last amended by section 21, chapter 67, Laws of 1983 1st ex. sess. and RCW 74.46.460 are each amended to read as follows:

          (1) Each contractor's reimbursement rates will be determined prospectively at least once each calendar year, to be effective July 1st.

          (2) Rates may be adjusted as determined by the department to take into account variations of more than ten percent in the distribution of patient classifications or changes in patient characteristics from the prior reporting year, program changes, changes in staffing levels at a facility required by the department, economic trends and conditions, and/or administrative review provided by RCW 74.46.780 and shall be adjusted for any capitalized additions or replacements made as a condition for licensure or certification.

          (3) (a) Where the contractor participated in the provisions of prospective cost-related reimbursement in effect prior to July 1, ((1983)) 1985, such contractor's prospective rate effective July 1, ((1983)) 1985, will be determined utilizing the contractor's desk-reviewed allowable costs for calendar year ((1982.

          (4) All prospective reimbursement rates for 1984 and thereafter shall be determined utilizing the prior year's desk-reviewed cost reports.)) 1984 together with costs which are disputed pursuant to RCW 74.46.475.

(b) When the items in dispute are finally resolved, rates shall be set retroactively to reflect the results of such resolution.

(c) The contractor shall be liable for interest on the amount due the department pursuant to such retrospective adjustment calculated at the statutory rate for interest on judgments from the date such payments were received by the contractor.

(4) The department shall use the same process for rate setting in each succeeding year.