WSR 09-12-063

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed May 28, 2009, 2:50 p.m. , effective July 1, 2009 ]


Effective Date of Rule: July 1, 2009.

Purpose: In accordance with sections 201 and 209 of the operating budget for fiscal years 2010 and 2011, the department will be adjusting its payment rates. The department is amending language in sections in chapter 388-550 WAC and WAC 388-502-0150 in order to meet the legislature's targeted budget expenditure levels for payment of hospital and hospital-related services provided to medical assistance clients. Changes include adding language to equalize rates paid for child birth, incorporating a prorated inpatient payment policy, adjusting rates to meet targeted inpatient and outpatient reductions, reducing the total period allowed for resubmission or modification of a claim other than a prescription drug or major trauma claim, incorporating into rule how per diem rates are determined for chronic pain services, and clarifying that WAC 388-550-4000 applies to both emergency and nonemergency services provided by out-of-state hospitals. In addition, the rules eliminate outdated information, and update and clarify language.

Citation of Existing Rules Affected by this Order: Amending WAC 388-502-0150, 388-550-2800, 388-550-3000, 388-550-3010, 388-550-3020, 388-550-3460, 388-550-3900, and 388-550-4000.

Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, 74.08.090 and 74.09.500.

Other Authority: 2009-11 Omnibus Operating Budget (ESHB 1244).

Adopted under notice filed as WSR 09-08-117 on March 31, 2009.

A final cost-benefit analysis is available by contacting Carolyn Adams, P.O. Box 45510, Olympia, WA 98504-5510, phone (360) 725-1854, fax (360) 753-9152, e-mail adamscr@dshs.wa.gov.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 8, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 8, Repealed 0.

Date Adopted: May 28, 2009.

Susan N. Dreyfus

Secretary

Reviser's note: The material contained in this filing exceeded the page-count limitations of WAC 1-21-040 for appearance in this issue of the Register. It will appear in the 09-13 issue of the Register.

Washington State Code Reviser's Office