FINAL BILL REPORT

SHB 1560

                                  C 260 L 89

BYHouse Committee on Health Care (originally sponsored by Representative Braddock; by request of Department of Social and Health Services)

Making changes to medical care provisions.

House Committe on Health Care

Rereferred House Committee on Appropriations

Senate Committee on Health Care & Corrections and Committee on Ways & Means

SYNOPSIS AS ENACTED

BACKGROUND:

Hospitals that receive funds based on the level of uncompensated care that they have provided relative to other hospitals are called "disproportionate share hospitals."  The state definition of "disproportionate share hospitals" conflicts with the federal definition in the Omnibus Budget Reconciliation Act of 1987 (OBRA).  To ensure Medicaid State Plan compliance for federal financial participation, it is necessary to revise the state definition.

Medical assistance payments for persons with AIDS are expected to grow substantially in the 1989-91 biennium. This amount can be reduced by purchasing "continuation coverage" (the purchase of insurance through the plan of a previous employer for not more than 18 months, as provided in federal law), or group health insurance coverage.  The Department of Social and Health Services (DSHS) cannot purchase this coverage without statutory authority.

The Department of Social and Health Services is authorized to enroll a portion of all AFDC recipients in managed health care systems.  However, all AFDC recipients in a geographic area must be enrolled in the same Health Maintenance Organization (HMO). This requirement does not allow flexibility if more than one HMO operates in the area.  Medicaid regulations also prohibit mandatory enrollment under a single system.

SUMMARY:

The Department of Social and Health Services is required to make payment adjustments to disproportionate share hospitals using factors prescribed by federal law.

The department is authorized to enroll AFDC recipients in a variety of managed health care programs that meet departmental requirements.

The department may purchase health insurance coverage for persons with AIDS who meet eligibility requirements established by the department.  This authorization terminates June 30, 1991.

An erroneous reference to the Emergency Medical Services statute is corrected.

VOTES ON FINAL PASSAGE:

      House 56  40

      Senate    39     7 (Senate amended)

      House 92   5 (House concurred)

EFFECTIVE:July 23, 1989