INTERPRETIVE OR POLICY STATEMENT
SOCIAL AND HEALTH SERVICES
Subject: Medicaid state plan amendment 03-011.
Effective Date: July 1, 2003.
Document Description: The Department of Social and Health Services (department), Medical Assistance Administration (MAA), is updating the Medicaid state plan through state plan amendment (SPA) 03-011 to further describe policy and methods for hospital payment explained in Attachment 4.19-A, Part I, and policy and methods changes in Attachment 4.19-B of the state plan. This is an updated public notice providing additional information to that provided in the public notice on June 18, 2003, and updated on August 6, 2003, in the State Register for SPA 03-011. These changes to payment method are justified to clarify the payment methods described and to comply with the state's current policy.
This update lists programs where changes to the plan are being made. Significant changes include:
Attachment 4.19-A, Part I:
• Elimination of the acute physical medicine and rehabilitation (PM&R) Level B program.
• Adding graduate medical education information about direct payments related to managed care.
• Clarification of payment method for out-of-state approved "exception to rule" care.
• Implementation of the small rural hospital indigent adult assistance program disproportionate share hospital (SRHIAAPDSH).
• Implementation of the nonrural hospital indigent adult assistance program disproportionate share hospital (NRHIAAPDSH).
• Implementation of the limited casualty program-psychiatric indigent inpatient (PII) for inpatient treatment of psychiatric indigent clients.
• Revision of medically indigent disproportionate share hospital (MIDSH) program.
• Revision of the small rural hospital assistance program disproportionate share hospital (SRHAPDSH) adding profitability factor to the payment calculation.
• Clarification of CMS 2552 Medicare cost reports reporting requirements set by the department, and authorized action if reports are not forwarded to the department timely.
Other minor clarifying text changes have also been made throughout the attachment.
• Addition of text describing enhanced trauma payment methods for physicians' services and outpatient hospital services.
• Pharmacy services text has minor clarifying changes and is also rearranged where it appears on the attachment pages as text for the enhanced trauma payment methods is added.
Written comments may be sent to Doug Porter, Assistant Secretary, Medical Assistance Administration, Department of Social and Health Services, P.O. Box 45080, Olympia, WA 98504-5080.
For more information regarding this clarification of language, please write to Larry Linn, Rates Analysis Section, Medical Assistance Administration, Department of Social and Health Services, P.O. Box 45510, Olympia, WA 98504-5510.
To receive a copy of the interpretive or policy statement, contact Ann Myers, Department of Social and Health Services, Medical Assistance Administration, Division of Policy and Analysis, P.O. Box 45533, Olympia, WA 98504, phone (360) 725-1345, weblink http://maa.dshs.wa.gov, TDD (800) 848-5429, fax (360) 586-9727, e-mail Myersea@dshs.wa.gov.
September 23, 2003
E. A. Myers