Revised Code of Washington
Chapter 74.09 - Medical Care.
74.09.611 - Hospital quality incentive payments—Noncritical access hospitals.

RCW 74.09.611
Hospital quality incentive payments—Noncritical access hospitals.

(1) If sufficient funds are made available as provided in subsection (2) of this section the authority, in collaboration with the Washington state hospital association, shall design a system of hospital quality incentive payments for noncritical access hospitals. The system must be based upon the following principles:
(a) Evidence-based treatment and processes must be used to improve health care outcomes for hospital patients;
(b) Effective purchasing strategies to improve the quality of health care services should involve the use of common quality improvement measures by public and private health care purchasers, while recognizing that some measures may not be appropriate for application to specialty pediatric, psychiatric, or rehabilitation hospitals;
(c) Quality measures chosen for the system should be consistent with the standards that have been developed by national quality improvement organizations, such as the national quality forum, the federal centers for medicare and medicaid services, or the federal agency for healthcare research and quality. New reporting burdens to hospitals should be minimized by giving priority to measures hospitals are currently required to report to governmental agencies, such as the hospital compare measures collected by the federal centers for medicare and medicaid services;
(d) Benchmarks for each quality improvement measure should be set at levels that are feasible for hospitals to achieve, yet represent real improvements in quality and performance for a majority of hospitals in Washington state; and
(e) Hospital performance and incentive payments should be designed in a manner such that all noncritical access hospitals are able to receive the incentive payments if performance is at or above the benchmark score set in the system established under this section.
(2) If hospital safety net assessment funds under RCW 74.60.020 are made available, such funds must be used to support an additional one percent increase in inpatient hospital rates for noncritical access hospitals that:
(a) Meet the quality incentive benchmarks established under this section; and
(b) Participate in Washington state hospital association collaboratives related to the benchmarks in order to improve care and promote sharing of best practices with other hospitals.
(3) Funds directed from any other lawful source may also be used to support the purposes of this section.

[ 2013 2nd sp.s. c 17 § 18.]
NOTES:

Effective date—2013 2nd sp.s. c 17: See note following RCW 74.60.005.

Structure Revised Code of Washington

Revised Code of Washington

Title 74 - Public Assistance

Chapter 74.09 - Medical Care.

74.09.010 - Definitions.

74.09.015 - Nurse hotline, when funded.

74.09.035 - Medical care services—Eligibility, standards—Limits.

74.09.037 - Identification card—Social security number restriction.

74.09.050 - Director's powers and duties—Personnel—Medical screeners—Medical director.

74.09.053 - Annual reporting requirement (as amended by 2009 c 479).

74.09.055 - Copayment, deductible, coinsurance, other cost-sharing requirements authorized.

74.09.075 - Employability and disability evaluation—Medical condition—Medical reports—Medical consultations and assistance.

74.09.080 - Methods of performing administrative responsibilities.

74.09.120 - Purchases of services, care, supplies—Nursing homes—Veterans' homes—Institutions for persons with intellectual disabilities—Institutions for mental diseases.

74.09.150 - Personnel to be under existing merit system.

74.09.160 - Presentment of charges by contractors.

74.09.171 - Contracts for medicaid services—Border communities.

74.09.180 - Chapter does not apply if another party is liable—Exception—Subrogation—Lien—Reimbursement—Delegation of lien and subrogation rights.

74.09.185 - Third party has legal liability to make payments—State acquires rights—Lien—Equitable subrogation does not apply.

74.09.190 - Religious beliefs—Construction of chapter.

74.09.195 - Audits of health care providers by the authority—Requirements—Procedure.

74.09.200 - Audits and investigations—Legislative declaration—State authority.

74.09.210 - Fraudulent practices—Penalties.

74.09.215 - Medicaid fraud penalty account.

74.09.220 - Liability for receipt of excess payments.

74.09.230 - False statements, fraud—Penalties.

74.09.240 - Bribes, kickbacks, rebates—Self-referrals—Penalties.

74.09.250 - False statements regarding institutions, facilities—Penalties.

74.09.260 - Excessive charges, payments—Penalties.

74.09.270 - Failure to maintain trust funds in separate account—Penalties.

74.09.280 - False verification of written statements—Penalties.

74.09.290 - Audits and investigations of providers—Patient records—Penalties.

74.09.295 - Disclosure of involuntary commitment information.

74.09.300 - Department to report penalties to appropriate licensing agency or disciplinary board.

74.09.315 - Whistleblowers—Workplace reprisal or retaliatory action.

74.09.325 - Reimbursement of a health care service provided through telemedicine or store and forward technology—Audio-only telemedicine.

74.09.327 - Audio-only telemedicine—Fee-for-service reimbursement.

74.09.328 - Use of substitute providers—When permitted—Reimbursement requirements.

74.09.330 - Reimbursement methodology for ambulance services—Transport of a medical assistance enrollee to a mental health facility or chemical dependency program.

74.09.335 - Reimbursement of health care services provided by fire departments—Adoption of standards.

74.09.340 - Personal needs allowance, adjusted.

74.09.390 - Access to baby and child dentistry program—Coverage for eligible children—Authority's duties—Report to legislature.

74.09.395 - Access to baby and child dentistry program—Outreach and engagement—Stakeholder collaboration.

74.09.402 - Children's health care—Findings—Intent.

74.09.460 - Children's affordable health coverage—Findings—Intent.

74.09.470 - Children's affordable health coverage—Authority duties.

74.09.4701 - Apple health for kids—Unemployment compensation.

74.09.475 - Newborn delivery services to medical assistance clients—Policies and procedures—Reporting.

74.09.480 - Performance measures—Provider rate increases—Report.

74.09.490 - Children's mental health—Improving medication management and care coordination.

74.09.495 - Access to children's behavioral health services—Report to legislature.

74.09.4951 - Children and youth behavioral health work group—Advisory groups—Report to governor and legislature.

74.09.497 - Authority review of payment codes available to health plans and providers related to primary care and behavioral health—Requirements—Principles considered—Matrices—Reporting.

74.09.500 - Medical assistance—Established.

74.09.510 - Medical assistance—Eligibility.

74.09.515 - Medical assistance—Coverage for youth released from confinement.

74.09.520 - Medical assistance—Care and services included—Funding limitations.

74.09.522 - Medical assistance—Agreements with managed health care systems for provision of services to medicaid recipients—Principles to be applied in purchasing managed health care.

74.09.5222 - Medical assistance—Section 1115 demonstration waiver request.

74.09.5223 - Findings—Chronic care management.

74.09.5225 - Medical assistance—Payments for services provided by rural hospitals—Participation in Washington rural health access preservation pilot.

74.09.5229 - Primary care health homes—Chronic care management—Findings—Intent.

74.09.523 - PACE program—Definitions—Requirements.

74.09.530 - Medical assistance—Powers and duties of authority.

74.09.540 - Medical assistance—Working individuals with disabilities—Intent.

74.09.545 - Medical assistance or limited casualty program—Eligibility—Agreements between spouses to transfer future income—Community income.

74.09.555 - Medical assistance—Reinstatement upon release from confinement—Expedited eligibility determinations.

74.09.557 - Medical assistance—Complex rehabilitation technology products.

74.09.565 - Medical assistance for institutionalized persons—Treatment of income between spouses.

74.09.575 - Medical assistance for institutionalized persons—Treatment of resources.

74.09.585 - Medical assistance for institutionalized persons—Period of ineligibility for transfer of resources.

74.09.595 - Medical assistance for institutionalized persons—Due process procedures.

74.09.597 - Medical assistance—Durable medical equipment and medical supplies—Providers.

74.09.600 - Post audit examinations by state auditor.

74.09.605 - Incorporation of outcomes/criteria into contracts with managed care organizations.

74.09.611 - Hospital quality incentive payments—Noncritical access hospitals.

74.09.630 - Opioid overdose reversal medications—Reimbursement.

74.09.632 - Opioid overdose reversal medications—Technical assistance—Written materials.

74.09.634 - Opioid overdose reversal medications—Bulk purchasing and distribution program.

74.09.640 - Opioid use disorder—Nonpharmacologic treatments.

74.09.645 - Opioid use disorder—Coverage without prior authorization.

74.09.650 - Prescription drug assistance program.

74.09.653 - Drug reimbursement policy recommendations.

74.09.655 - Smoking cessation assistance.

74.09.657 - Findings—Family planning services expansion.

74.09.658 - Home health—Reimbursement—Telemedicine.

74.09.659 - Family planning waiver program request.

74.09.660 - Prescription drug education for seniors—Grant qualifications.

74.09.670 - Medical assistance benefits—Incarcerated or committed persons—Suspension.

74.09.671 - Incarcerated persons—Local jails—Behavioral health services—Federal funding.

74.09.672 - Inmates of a public institution—Exclusion from medicaid coverage—Work release and partial confinement programs.

74.09.675 - Gender affirming care services—Prohibited discrimination.

74.09.700 - Medical care—Limited casualty program.

74.09.710 - Chronic care management programs—Medical homes—Definitions.

74.09.715 - Access to dental care.

74.09.717 - Dental health aide therapist services—Federal funding.

74.09.719 - Compact of free association islander dental care program.

74.09.720 - Prevention of blindness program.

74.09.725 - Prostate cancer screening.

74.09.730 - Disproportionate share hospital adjustment.

74.09.741 - Adjudicative proceedings.

74.09.745 - Medicaid funding for home visiting services—Recommendations to legislature.

74.09.748 - Regional service areas—Certain reimbursements required or allowed upon adoption of fully integrated managed health care system.

74.09.756 - Medicaid and state children's health insurance program demonstration project.

74.09.758 - Medicaid procurement of services—Value-based contracting for medicaid and public employee purchasing.

74.09.760 - Short title—1989 1st ex.s. c 10.

74.09.770 - Maternity care access system established.

74.09.780 - Reservation of legislative power.

74.09.790 - Definitions.

74.09.800 - Maternity care access program established.

74.09.810 - Alternative maternity care service delivery system established—Remedial action report.

74.09.820 - Maternity care provider's loan repayment program.

74.09.825 - Donor human milk—Standards—Federal funding.

74.09.830 - Postpartum health care coverage.

74.09.850 - Conflict with federal requirements.

74.09.860 - Request for proposals—Foster children—Integrated managed health and behavioral health care—Continuation of health care benefits following reunification.

74.09.870 - Regional service areas—Establishment.

74.09.871 - Behavioral health services—Contracting process.

74.09.875 - Reproductive health care services—Prohibited discrimination.

74.09.877 - Statewide plan to implement coordinated specialty care programs providing early identification and intervention for psychosis.

74.09.880 - Z code collection—Incentives and funding.

74.09.885 - Apple health and homes program—Definitions.

74.09.886 - Apple health and homes program—Establishment—Eligibility—Services.

74.09.888 - Apple health and homes program—Authority duties—Funding—Reports to legislature.

74.09.900 - Other laws applicable.

74.09.920 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.