WSR 14-07-025
(Washington Apple Health)
[Filed March 7, 2014, 3:35 p.m.]
Subject of Possible Rule Making: WAC 182-550-2800 Payment methods and limits—Inpatient hospital services for medicaid and SCHIP clients, 182-550-3350 Outlier costs, 182-550-3600 Diagnosis-related group (DRG) payment—Hospital transfers, 182-550-3700 DRG high-cost and low-cost outliers, and new system DRG and per diem high outliers, 182-550-4500 Payment method—Ratio of costs-to-charges (RCC), 182-550-4800 Hospital payment methods—State administered programs, and other rules as appropriate.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 41.05.021, chapter 74.60 RCW.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: Revising the outlier rules is an integral part of updating inpatient hospital payment rates to reflect changes in hospital industry practices and state medicaid payment policies as requested by the legislature.
The update called "rebasing" is completed by a consultant hired by the state of Washington in coordination with stakeholders including hospitals, the Washington State Hospital Association, office of financial management, legislative staff and others.
During the course of this review, the health care authority (HCA) may identify additional changes that are required in order to improve clarity or update policy.
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 Jason R. P. Crabbe, Rules and Publications Program Manager, HCA, Legal and Administrative Services, P.O. Box 45504, Olympia, WA 98504-5504, fax (360) 586-9727, TTY 1-800-848-5429, e-mail
Match [March] 7, 2014
Kevin M. Sullivan
Rules Coordinator