In May of 2007 the Washington Legislature passed SB 5930 providing for the creation of a new Strategic Health Planning Office in the Office of Financial Management (OFM).  The purpose of this office is to establish health planning policies and goals that relate to the regional availability of health care facilities and services, quality of care, and cost of care. 
On January 29, 2010,  OFM released its draft Health Resources Strategy Report.  OFM will be accepting comments through February 5, 2010.

A revised WAC 458-16-260 – Nonprofit day care centers, libraries, orphanages, homes for sick or inform, hospitals, outpatient dialysis facilities – will take effect at the end of January 2010, clarifying what property owned by a nonprofit hospital is eligible for a tax exemption from Washington state property taxes.

The amended WAC changes the focus of the property tax exemption from whether the property is for in-patient use, to now focusing on whether the property is fully integrated into a licensed hospital unit.  The exemption now covers: “all buildings that are currently licensed as part of hospital pursuant to 70.41 or 71.12 RCW and are part of an integrated, interrelated, homogenous unit exclusively used for hospital purposes.  The licensed hospital must be able to provide health care services to inpatients over a continuous period of twenty-four hours or more.”  Administrative and support facilities, hospital owned employee residences, and temporary residential units used to house families of inpatients are also included in the exemption. 

The exemption excludes clinics and physician’s offices that are not licensed as part of the hospital and where patients are not regularly kept as bed patients for 24 hours or more.  The amendment also removes the requirement that the property be in use and irrevocably dedicated to the exempt purpose of the nonprofit organization.

Coordination of Benefits.  Effective September 1, 2009 medical insurance plans will be subject to clearly defined time frame requirements for the processing of claims involving coordination of benefits.  The goal of the amended regulation is to expedite the payment of both the primary and secondary claims.  Amendments to WAC 284-51-215 require plans to cooperate when more than one plan covers an individual, and to determine which plan is primary within 30 days.  The primary plan is then required to pay 95% of claims within 30 days of the determination it is the primary carrier, subject to extension if the plan must wait for needed information from the provider.  The amendments also require the secondary plan to process claims within 30 days of receipt of the primary plan’s explanation of benefit information needed for the secondary plan to process the claim.  If the secondary plan receives a claim without adequate information from the primary plan, it must notify the enrollee or primary plan as soon as possible, but no longer than 30 days.  If a primary plan does not adjudicate a clean and complete claim within 60 days, the provider or enrollee may submit the claim to the secondary plan which must then pay the claim as the primary plan within 30 days.  The new provisions do not apply when Medicare is the primary plan.  These new provisions should provide both enrollees and providers with an important new tool to expedite the timely processing and payment of claims involving coordination of benefits.  As new provider and facility agreements are negotiated with health plans in Washington, these amendments should be incorporated into the agreement language governing coordination and payment of benefits. 

To see the revised rule click here.