WSR 12-07-074



(Medicaid Program)

[ Filed March 20, 2012, 11:07 a.m. ]

Subject of Possible Rule Making: Amending WAC 182-531-2000 Increased payments for physician-related services for qualified trauma cases and 182-550-5450 Supplemental distributions to approved trauma service centers.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 41.05.021.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: On July 1, 2012, a substantial number (100,000+) of fee-for-service (FFS) clients will be shifted to managed care. The health care authority (HCA) currently makes supplemental payments to trauma care providers for FFS clients who meet specified criteria, but trauma care services provided to managed care clients are not eligible for such payments. The proposed rules/amendments will allow HCA to make supplemental payments to trauma care providers for clients in managed care. HCA will also apply for a federal waiver to pay hospitals the supplemental payments outside the capitation rate. These steps will help prevent the loss of up to $7.5M per year in federal matching funds from the statewide trauma care system. The proposed rules also include housekeeping changes (e.g., replacing "DSHS" with "HCA").

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: HCA and the department of health (DOH) jointly manage funding and administration of the statewide trauma care system. HCA will coordinate with DOH the development and implementation of necessary policy changes through regular ongoing meetings and communications with trauma system stakeholders.

Process for Developing New Rule: HCA welcomes the public to take part in developing the rules. Anyone interested should contact the staff person identified below. At a later date, HCA will file a notice of proposed rule making (CR-102) with the office of the code reviser. A copy of the proposal will be sent to everyone on the mailing list and to anyone who requests a copy.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kevin Sullivan, HCA Rules Coordinator, P.O. Box 45504, Olympia, WA 98504-5504, phone (360) 725-1344, fax (360) 586-9727, TTY 1-800-848-5429.

March 20, 2012

Kevin M. Sullivan

Rules Coordinator

Washington State Code Reviser's Office