PDFWAC 296-23A-0240
How does the department define and pay a new hospital?
New hospitals are those open for less than one year prior to the implementation of the department's most recent hospital payment rates. The department will pay new hospitals according to the following table:
Hospital Type or Location | What Diagnosis Related Group (DRG) base price applies? | What Per Diem Payment Rates Apply? | What percent of allowed charges (POAC) factor applies? |
Military, Veterans Administration, State Psychiatric, Health Maintenance Organization, Children’s, | Exempt | Exempt | Paid 100% of allowed charges |
Chronic Pain Management Program | Exempt, paid per department agreement | Exempt, paid per department agreement | Exempt, Paid per department agreement |
Other Washington Hospital | Weighted median case-mix adjusted average cost per case for Washington DRG hospitals, except major teaching hospitals | Washington statewide average per diem rates | Washington statewide average POAC |
A new hospital will be paid using its hospital-specific POAC within three years of receiving a provider account number(s) from the department.
[Statutory Authority: RCW 51.04.030 and 51.12.330. WSR 06-12-073, § 296-23A-0240, filed 6/6/06, effective 7/7/06. Statutory Authority: RCW 51.04.020, 51.04.030, 51.36.080. WSR 00-06-027, § 296-23A-0240, filed 2/24/00, effective 3/26/00; WSR 97-06-066, § 296-23A-0240, filed 2/28/97, effective 4/1/97.]