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WAC 296-23A-0520

How does the department pay for high outlier cases?

Cases defined as high cost outliers will be reimbursed at the diagnosis-related-group (DRG) payment rate plus one hundred percent of costs in excess of the threshold. Costs are determined by multiplying the allowed charges by the hospital specific percent of allowed charges (POAC) factor.
[Statutory Authority: RCW 51.04.020, 51.04.030 and 51.36.080. WSR 97-06-066, ยง 296-23A-0520, filed 2/28/97, effective 4/1/97.]
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