Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-550 - Hospital services
Section 182-550-7550 - OPPS payment enhancements
Universal Citation: WA Admin Code 182-550-7550
Current through Register Vol. 24-18, September 15, 2024
(1) Pediatric adjustment.
(a) The medicaid agency establishes a policy
adjustor to be applied to all enhanced ambulatory patient group (EAPG) services
for clients under age 18 years.
(b)
Effective July 1, 2014, this adjustor equals one point thirty-five
(1.35).
(2) Chemotherapy and combined chemotherapy/pharmacotherapy adjustment.
(a) The agency establishes a policy adjustor
to be applied to services grouped as chemotherapy drugs or combined
chemotherapy and pharmacotherapy drugs.
(b) Effective July 1, 2014, this adjustor
equals one point one (1.1).
(3) Sole community hospitals.
(a) For sole community hospital's rate
enhancements, the agency multiplies the in-state hospital's specific EAPG
conversion factor by a multiplier if the hospital meets all of the following
criteria per
RCW
74.09.5225:
(i) Be certified by CMS as a sole community
hospital as of January 1, 2013;
(ii) Have a level III adult trauma service
designation from the Washington state department of health (DOH) as of January
1, 2014;
(iii) Have less than 150
acute care licensed beds in fiscal year 2011; and
(iv) Be owned and operated by the state or a
political subdivisions.
(b) As of July 1, 2021, through June 30,
2023, an additional increase may be applied for hospitals that accept single
bed certifications per
RCW
71.05.745.
|
Enhancement Multiplier by Year |
||||||
|
Provider Category |
Effective For the Dates |
|||||
|
07/01/2015 - 06/30/2020 |
07/01/2020 - 06/30/2021 |
07/01/2021 - 06/30/2022 |
07/01/2022 - 06/30/2023 |
07/01/2023 - 12/31/2023 |
01/01/2024 - 06/30/2024 |
|
|
Sole community hospital |
1.25 |
1.5 |
N/A |
1.25 |
1.25 |
1.50 |
|
Sole community hospital accepting single bed certifications |
N/A |
N/A |
1.5 |
1.5 |
N/A |
N/A |
Statutory Authority: RCW 41.05.021 and chapter 74.60 RCW. WSR 14-14-049, § 182-550-7550, filed 6/25/14, effective 7/26/14.
Disclaimer: These regulations may not be the most recent version. Washington may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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