WSR 13-15-042
(Medicaid Program)
[Filed July 11, 2013, 2:24 p.m.]
Subject of Possible Rule Making: WAC 182-550-1050 Hospital services definitions, 182-550-2511 Acute PM&R definitions (repeal), 182-550-2570 LTAC program definitions (repeal), 182-550-2900 Payment limits—Inpatient hospital services, 182-550-3000 Payment method—DRG, 182-550-3010 Payment method—Per diem payment, 182-550-3020 Payment method—Bariatric surgery—Per case payment, 182-550-3100 Calculating DRG relative weights, 182-550-3150 Base period costs and claims data, 182-550-3200 Medicaid cost proxies, 182-550-3250 Indirect medical education costs—Conversion factors, per diem rates, and per case rates, 182-550-3381 Payment methodology for acute PM&R services and administrative day services, 182-550-3450 Payment method for calculating medicaid DRG conversion factor rates, 182-550-3460 Payment method—Per diem rate, 182-550-3800 Rebasing and recalibration, 182-550-3900 Payment method—Bordering city hospitals and critical border hospitals, 182-550-4000 Payment method—Out-of-state hospitals, 182-550-4100 Payment method—New hospitals, 182-550-4300 Hospitals and units exempt from the DRG payment method, 182-550-4400 Services—Exempt from DRG payment, 182-550-4800 Hospital payment methods—State administered programs, 182-550-7050 OPPS—Definitions (repeal), and Other rules as appropriate.
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: During the rebasing of inpatient and outpatient rates, the agency, along with consultants and stakeholders, reviews and revises how the agency pays hospitals for caring for medicaid clients. During this process, payment methods and rates change. These changes must be reflected in Washington Administrative Code.
During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy.
Process for Developing New Rule: The health care authority (HCA) welcomes the public to take part in developing this rule. If interested, contact the person identified below to receive an early rule draft to review. After the early review, HCA will send a notice of proposed rule making (CR-102) to everyone receiving this notice and 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 Jason Crabbe, P.O. Box 45504, Olympia, WA 98504-2716, fax (360) 586-9727, TTY 1-800-848-5429, e-mail
July 11, 2013
Kevin M. Sullivan
Rules Coordinator