reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-451 - Hospitals - Assessments and related reports › Section 246-451-060 - Penalties for violation

Current through Register Vol. 24-14, July 15, 2024
RCW  70.170.070 provides that every
				  person who shall violate or knowingly aid and abet the violation of
				  chapter
				  70.170 RCW or any valid
				  orders, rules, or regulations thereunder, or who fails to perform any act which
				  that chapter makes it his/her duty to perform shall be guilty of a misdemeanor.
				  Following official notice to the accused by the department of the existence of
				  an alleged violation, each day upon which a violation occurs shall constitute a
				  separate violation. Any person violating the provisions of
				  chapter
				  70.170 RCW may be
				  enjoined from continuing such violation. Failure to remit the payment required
				  by WAC 246-451-030 or file the reports
				  required by WAC
				  246-451-050 shall constitute a
				  violation, and the department may levy a civil penalty not to exceed one
				  thousand dollars per day for each day following official notice of the
				  violation by the department. The department may grant extensions of time to
				  remit the payment or file the reports, in which cases failure to file the
				  reports shall not constitute a violation until the extension period has
				  expired.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-451-060, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-451-060, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 RCW 70.39.180. 86-11-041 (Order 86-01, Resolution No. 86-01), §
					 261-10-080, filed 5/16/86; Order 74-03, § 261-10-080, filed
					 2/15/74.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-453 - Hospital charity care › Section 246-453-001 - Purpose

Current through Register Vol. 24-14, July 15, 2024
This chapter is adopted by the Washington state department of
				  health to implement the provisions of
				  chapter
				  70.170 RCW. These
				  sections relate to hospital policies for charity care, bad debt and emergency
				  medical care, including admission practices, the compilation and measurement of
				  the level of charity care services provided by each hospital, and penalties for
				  violation of these provisions.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-453-001, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  70.170.060. 91-05-048 (Order 142), §
					 246-453-001, filed 2/14/91, effective 3/17/91. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-453-001, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 85-01-007 (Order 84-07, Resolution No. 84-07), §
					 261-14-010, filed 12/7/84.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-453 - Hospital charity care › Section 246-453-020 - Uniform procedures for the identification of indigent persons

Current through Register Vol. 24-14, July 15, 2024
For the purpose of identifying those patients that will be
				  classified as indigent persons, all hospitals shall adopt and implement the
				  following procedures:
(1) The
				initiation of collection efforts directed at the responsible party shall be
				precluded pending an initial determination of sponsorship status, provided that
				the responsible party is cooperative with the hospital's efforts to reach an
				initial determination of sponsorship status;
(a) Collection efforts shall include any
				demand for payment or transmission of account documents or information which is
				not clearly identified as being intended solely for the purpose of transmitting
				information to the responsible party;
(b) The initial determination of sponsorship
				status shall be completed at the time of admission or as soon as possible
				following the initiation of services to the patient;
(c) If the initial determination of
				sponsorship status indicates that the responsible party may meet the criteria
				for classification as an indigent person, as described in WAC
				246-453-040, collection efforts
				directed at the responsible party will be precluded pending a final
				determination of that classification, provided that the responsible party is
				cooperative with the hospital's reasonable efforts to reach a final
				determination of sponsorship status;
(d) During the pendency of the initial
				determination of sponsorship status and/or the final determination of the
				applicability of indigent person criteria, hospitals may pursue reimbursement
				from any third-party coverage that may be identified to the hospital;
(e) The requirements of this subsection shall
				not apply to clinics operated by disproportionate share hospitals, as defined
				and identified by the department of social and health services, medical
				assistance services, provided that patients are advised of the availability of
				charity care at the time that services are provided and when presented with a
				request for payment.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-453 - Hospital charity care › Section 246-453-030 - Data requirements for the identification of indigent persons

Current through Register Vol. 24-14, July 15, 2024
(1) For the purpose
				of reaching an initial determination of sponsorship status, hospitals shall
				rely upon information provided orally by the responsible party. The hospital
				may require the responsible party to sign a statement attesting to the accuracy
				of the information provided to the hospital for purposes of the initial
				determination of sponsorship status.
(2) Any one of the following documents shall
				be considered sufficient evidence upon which to base the final determination of
				charity care sponsorship status, when the income information is annualized as
				may be appropriate:
(a) A "W-2" withholding
				statement;
(b) Pay stubs;
(c) An income tax return from the most
				recently filed calendar year;
(d)
				Forms approving or denying eligibility for medicaid and/or state-funded medical
				assistance;
(e) Forms approving or
				denying unemployment compensation; or
(f) Written statements from employers or
				welfare agencies.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-453 - Hospital charity care › Section 246-453-040 - Uniform criteria for the identification of indigent persons

Current through Register Vol. 24-14, July 15, 2024
For the purpose of identifying indigent persons, all
				  hospitals shall use the following criteria:
(1) All responsible parties with family
				income equal to or below one hundred percent of the federal poverty standard,
				adjusted for family size, shall be determined to be indigent persons qualifying
				for charity sponsorship for the full amount of hospital charges related to
				appropriate hospital-based medical services that are not covered by private or
				public third-party sponsorship;
(2)
				All responsible parties with family income between one hundred one and two
				hundred percent of the federal poverty standard, adjusted for family size,
				shall be determined to be indigent persons qualifying for discounts from
				charges related to appropriate hospital-based medical services in accordance
				with the hospital's sliding fee schedule and policies regarding individual
				financial circumstances;
(3)
				Hospitals may classify any individual responsible party whose income exceeds
				two hundred percent of the federal poverty standard, adjusted for family size,
				as an indigent person eligible for a discount from charges based upon that
				responsible party's individual financial circumstances.
Statutory Authority:
					 RCW
					 70.170.060. 91-05-048 (Order 142), §
					 246-453-040, filed 2/14/91, effective
					 3/17/91.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-453 - Hospital charity care › Section 246-453-050 - Guidelines for the development of sliding fee schedules

Current through Register Vol. 24-14, July 15, 2024
All hospitals shall, within ninety days of the adoption of
				  these rules, implement a sliding fee schedule for determination of discounts
				  from billed charges for responsible parties meeting the criteria in WAC
				  246-453-040(2).
				  These sliding fee schedules must be made available upon request.
(1) In developing these sliding fee
				schedules, hospitals shall consider the following guidelines:
(a) The sliding fee schedule shall consider
				the level of charges that are not covered by any public or private sponsorship
				in relation to or as a percentage of the responsible party's family
				income;
(b) The sliding fee
				schedule shall determine the maximum amount of charges for which the
				responsible party will be expected to provide payment, with flexibility for
				hospital management to hold the responsible party accountable for a lesser
				amount after taking into account the specific financial situation of the
				responsible party;
(c) The sliding
				fee schedule shall take into account the potential necessity for allowing the
				responsible party to satisfy the maximum amount of charges for which the
				responsible party will be expected to provide payment over a reasonable period
				of time, without interest or late fees; and
(d) Hospital policies and procedures
				regarding the sliding fee schedule shall specify the individual financial
				circumstances which may be considered by appropriate hospital personnel for
				purposes of adjusting the amount resulting from the application of the sliding
				fee schedule, such as:
(i) Extraordinary
				nondiscretionary expenses relative to the amount of the responsible party's
				medical care expenses;
(ii) The
				existence and availability of family assets, which may only be considered with
				regard to the applicability of the sliding fee schedule;
(iii) The responsible party's future income
				earning capacity, especially where his or her ability to work in the future may
				be limited as a result of illness; and
(iv) The responsible party's ability to make
				payments over an extended period of time.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-453 - Hospital charity care › Section 246-453-060 - Denial of access to emergency care based upon ability to pay and transfer of patients with emergency medical conditions or active labor

Current through Register Vol. 24-14, July 15, 2024
(1) No hospital or
				its medical staff shall adopt or maintain admission practices or policies which
				result in:
(a) A significant reduction in the
				proportion of patients who have no third-party coverage and who are unable to
				pay for hospital services;
(b) A
				significant reduction in the proportion of individuals admitted for inpatient
				hospital services for which payment is, or is likely to be, less than the
				anticipated charges for or costs of such services; or
(c) The refusal to admit patients who would
				be expected to require unusually costly or prolonged treatment for reasons
				other than those related to the appropriateness of the care available at the
				hospital.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-453 - Hospital charity care › Section 246-453-070 - Standards for acceptability of hospital policies for charity care and bad debts

Current through Register Vol. 24-14, July 15, 2024
(1) Each hospital
				shall develop, and submit to the department, charity care policies, procedures,
				and sliding fee schedules consistent with the requirements included in WAC
				246-453-020,
				246-453-030,
				246-453-040, and
				246-453-050. Any subsequent
				modifications to those policies, procedures, and sliding fee schedules must be
				submitted to the department no later than thirty days prior to their adoption
				by the hospital.
(2) Each hospital
				shall develop, and submit to the department, bad debt policies and procedures,
				including reasonable and uniform standards for collection of the unpaid
				portions of hospital charges that are the patient's responsibility. These
				standards are to be part of each hospital's system of accounts receivable
				management manuals, which support hospital collection policies. Manuals should
				cover procedures for preadmission, admission, discharge, outpatient
				registration and discharge, billing, and credit and collections. All subsequent
				modifications to these bad debt policies must be submitted to the department no
				later than thirty days prior to their adoption by the hospital.
(3) The department shall review the charity
				care and bad debt policies and procedures submitted in accordance with the
				provisions of this section. If any of the policies and procedures do not meet
				the requirements of this section or WAC
				246-453-020,
				246-453-030,
				246-453-040, or
				246-453-050, the department shall
				reject the policies and procedures and shall so notify the hospital. Such
				notification shall be in writing, addressed to the hospital's chief executive
				officer or equivalent, and shall specify the reason(s) that the policies and
				procedures have been rejected. Any such notification must be mailed within
				fourteen calendar days of the receipt of the hospital's policies and
				procedures. Within fourteen days of the date of the rejection notification, the
				hospital shall revise and resubmit the policies and procedures.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-453-070, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  70.170.060. 91-05-048 (Order 142), §
					 246-453-070, filed 2/14/91, effective 3/17/91. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-453-070, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 85-01-007 (Order 84-07, Resolution No. 84-07), §
					 261-14-030, filed 12/7/84.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-453 - Hospital charity care › Section 246-453-080 - Reporting requirements

Current through Register Vol. 24-14, July 15, 2024
Each hospital shall compile and report data to the department
				  with regard to the amount of charity care provided, in accordance with
				  instructions issued by the department.
Statutory Authority:
					 RCW
					 70.170.060. 91-05-048 (Order 142), §
					 246-453-080, filed 2/14/91, effective 3/17/91. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-453-080, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 85-01-007 (Order 84-07, Resolution No. 84-07), §
					 261-14-040, filed 12/7/84.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-453 - Hospital charity care › Section 246-453-090 - Penalties for violation

Current through Register Vol. 24-14, July 15, 2024
(1)
				Failure to file the policies, procedures, and sliding fee schedules as required
				by WAC 246-453-070 or the reports
				required by WAC
				246-453-080 shall constitute a
				violation of
				RCW
				 70.170.060, and the department will levy a
				civil penalty of one thousand dollars per day for each day following official
				notice of the violation. The department may grant extensions of time to file
				the reports, in which cases failure to file the reports shall not constitute a
				violation until the extension period has expired.
(2) Failure to comply with other provisions
				of chapter 70.170
				RCW, and chapter 246-453 WAC, shall result in civil penalties as provided
				within RCW
				 70.170.070(2), with the
				exception that the terms "not exceeding" and "not to exceed" will be read to
				mean "of."
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-453-090, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  70.170.060. 91-05-048 (Order 142), §
					 246-453-090, filed 2/14/91, effective 3/17/91. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-453-090, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 RCW 70.39.180. 86-11-041 (Order 86-01, Resolution No. 86-01), §
					 261-14-090, filed 5/16/86.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-454 - Hospitals-System of accounting, financial reporting, budgeting, cost allocation › Section 246-454-001 - Purpose

Current through Register Vol. 24-14, July 15, 2024
This chapter is adopted by the Washington state department of
				  health to implement the provisions of RCW 70.170.100 and
				  
										43.70.050 regarding the
				  establishment of a uniform system of accounting, financial reporting, budgeting
				  and cost allocation for hospitals in Washington state. This system shall be
				  utilized by each hospital to record and report to the department its revenues,
				  expenses, other income, other outlays, assets and liabilities, and units of
				  service and to submit information, as may be required by the department,
				  pertaining to the total financial needs of the hospital and the resources
				  available or expected to become available to meet such needs.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-454-001, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-454-001, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 84-20-066 (Order 84-05, Resolution No. 84-05), §
					 261-20-010, filed 10/1/84; 83-06-036 (Order 83-02, Resolution No. 83-02),
					 § 261-20-010, filed 2/28/83; 81-06-016 (Order 81-01, Resolution No.
					 R-81-01), § 261-20-010, filed
					 2/20/81.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-454 - Hospitals-System of accounting, financial reporting, budgeting, cost allocation › Section 246-454-010 - Definitions

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply throughout the chapter
				  unless the context clearly requires otherwise.
(1) "Department" means the Washington state
				department of health created by chapter 43.70 RCW.
(2) "Hospital" means any health care
				institution which is required to qualify for a license under chapter 70.41 RCW
				; or as a psychiatric hospital under chapter 71.12 RCW.
(3) "Manual" means the
Washington
				State Department of Health Accounting and Reporting Manual for
				Hospitals
, third edition adopted under WAC
				246-454-020.
(4) "System of accounts" means the list of
				accounts, code numbers, definitions, units of measure, and principles and
				concepts included in the manual.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-454-010, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-454-010, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 84-20-066 (Order 84-05, Resolution No. 84-05), §
					 261-20-020, filed 10/1/84; 83-06-036 (Order 83-02, Resolution No. 83-02),
					 § 261-20-020, filed 2/28/83; 81-06-016 (Order 81-01, Resolution No.
					 R-81-01), § 261-20-020, filed
					 2/20/81.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-454 - Hospitals-System of accounting, financial reporting, budgeting, cost allocation › Section 246-454-050 - Submission of year-end report

Current through Register Vol. 24-14, July 15, 2024
(1)
				Each hospital annually shall file its year-end report with the department
				within one hundred twenty days after the close of its fiscal year in the form
				and manner specified in the manual: Provided, however, The one hundred
				twenty-day period may be extended up to and including an additional sixty days
				upon submission of adequate justification to the department. If more than one
				hospital is operated by the reporting organization, the information required by
				this section shall be reported for each hospital separately.
(2) Information submitted pursuant to this
				section shall be certified by the hospital's administrative and financial
				officers, that such reports, to the best of their knowledge and belief, have
				been prepared in accordance with the prescribed system of accounting and
				reporting, and fairly state the financial position of the hospital as of the
				specified date. The department also may require attestation as to such
				statements from responsible officials of the hospital so designated by the
				governing body, if any, of the hospital.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-454-050, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-454-050, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 84-20-066 (Order 84-05, Resolution No. 84-05), §
					 261-20-050, filed 10/1/84; 83-06-036 (Order 83-02, Resolution No. 83-02),
					 § 261-20-050, filed 2/28/83; 81-06-016 (Order 81-01, Resolution No.
					 R-81-01), § 261-20-050, filed
					 2/20/81.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-454 - Hospitals-System of accounting, financial reporting, budgeting, cost allocation › Section 246-454-070 - Submission of quarterly reports

Current through Register Vol. 24-14, July 15, 2024
Each hospital shall submit a quarterly summary utilization
				  and financial report within forty-five days after the end of each calendar
				  quarter. The quarterly report shall contain that information specified by the
				  department and shall be submitted in the form and manner specified by the
				  department.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-454-070, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-454-070, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 85-04-026 (Order 85-01, Resolution No. 85-01), §
					 261-20-057, filed 1/31/85.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-454 - Hospitals-System of accounting, financial reporting, budgeting, cost allocation › Section 246-454-080 - Alternative system of financial reporting

Current through Register Vol. 24-14, July 15, 2024
Upon receipt of a request in detail to the satisfaction of
				  the department, the department in its discretion may approve an alternative
				  system for reporting of information under WAC
				  246-454-030 or
				  246-454-050 by a hospital for
				  such period(s) or portion thereof as the department shall specify, if:
(1) The hospital charges no fee to users of
				its services, presents no billing, either direct or indirect, to users of its
				services, and presents no billing and accepts no payment for services from
				private or public insurers.
(2) The
				hospital is significantly different from other hospitals in one or more of the
				following respects: Size; financial structure; methods of payment for services;
				or scope, type, and method of providing services.
(3) The hospital has other pertinent
				distinguishing characteristics.
(4)
				Such alternative system will avoid otherwise unduly burdensome costs in meeting
				the requirements of the uniform reporting system established by the
				department.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-454-080, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-454-080, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 83-06-036 (Order 83-02, Resolution No. 83-02), §
					 261-20-060, filed 2/28/83; 81-06-016 (Order 81-01, Resolution No. R-81-01),
					 § 261-20-060, filed 2/20/81.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-454 - Hospitals-System of accounting, financial reporting, budgeting, cost allocation › Section 246-454-090 - Modifications of uniform system

Current through Register Vol. 24-14, July 15, 2024
The department, after due consideration, in its discretion,
				  may prepare and publish modifications of the manual, for such period and under
				  such conditions as the department shall determine. Such modifications shall be
				  prepared in the format of, and shall be adopted by the department as a rule
				  pursuant to chapter 34.04 [34.05 ] RCW. A copy of such modifications shall be
				  mailed to each hospital and manual holder of record.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-454-090, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-454-090, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 83-06-036 (Order 83-02, Resolution No. 83-02), §
					 261-20-070, filed 2/28/83; 81-06-016 (Order 81-01, Resolution No. R-81-01),
					 § 261-20-070, filed 2/20/81.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-454 - Hospitals-System of accounting, financial reporting, budgeting, cost allocation › Section 246-454-110 - Uniformly applicable interpretive rulings and minor manual modifications

Current through Register Vol. 24-14, July 15, 2024
(1) The department
				is authorized to make uniformly applicable interpretive rulings with respect to
				matters contained in the manual. The department is also authorized to correct
				typographical and coding errors as well as make other minor organizational
				modifications when such corrections and modifications appear to be
				necessary.
(2) Any such
				interpretive ruling, correction, or modification shall be in writing and
				distributed as an attachment to a consecutively numbered transmittal. Such
				transmittal shall describe the changes in detail and shall include instructions
				regarding the placement of such material in the manual. Each hospital and
				manual holder of record shall be sent a copy of any such transmittal together
				with all attachments.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-454-110, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-454-110, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 83-06-036 (Order 83-02, Resolution No. 83-02), §
					 261-20-080, filed 2/28/83; 81-06-016 (Order 81-01, Resolution No. R-81-01),
					 § 261-20-080, filed 2/20/81.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-454 - Hospitals-System of accounting, financial reporting, budgeting, cost allocation › Section 246-454-120 - Penalties for violation

Current through Register Vol. 24-14, July 15, 2024
RCW  70.170.070 provides that every
				  person who shall violate or knowingly aid and abet the violation of
				  chapter
				  70.170 RCW or any valid
				  orders, rules, or regulations thereunder, or who fails to perform any act which
				  that chapter makes it his/her duty to perform shall be guilty of a misdemeanor.
				  Following official notice to the accused by the department of the existence of
				  an alleged violation, each day upon which a violation occurs shall constitute a
				  separate violation. Any person violating the provisions of
				  chapter
				  70.170 RCW may be
				  enjoined from continuing such violation. Failure to file the reports required
				  by WAC 246-454-030(1),
				  246-454-050(1),
				  and 246-454-070 shall constitute a
				  violation, and the department may levy a civil penalty not to exceed one
				  thousand dollars per day for each day following official notice of the
				  violation by the department. The department may grant extensions of time to
				  file the reports, in which cases failure to file the reports shall not
				  constitute a violation until the extension period has
				  expired.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
					 RCW. 94-12-089, § 246-454-120, filed 6/1/94, effective 7/2/94. Statutory
					 Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-454-120, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 RCW 70.39.180. 86-11-041 (Order 86-01, Resolution No. 86-01), §
					 261-20-090, filed 5/16/86. Statutory Authority: Chapter 70.39 RCW. 85-04-026
					 (Order 85-01, Resolution No. 85-01), § 261-20-090, filed 1/31/85;
					 83-06-036 (Order 83-02, Resolution No. 83-02), § 261-20-090, filed
					 2/28/83.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-001 - Purpose

Current through Register Vol. 24-14, July 15, 2024
This chapter is adopted by the Washington state department of
				  health pursuant to
				  RCW
				   43.70.040 and
				  43.70.052 relating to the collection and maintenance of patient discharge data, including
				  data necessary for identification of discharges by diagnosis-related
				  groups.
Statutory Authority:
					 RCW
					  43.70.040 and
					 43.70.052. 07-09-091, §
					 246-455-001, filed 4/18/07, effective 5/23/07. Statutory Authority:
					 RCW
					  43.70.040 and [43.]70.170. 03-13-029, §
					 246-455-001, filed 6/10/03, effective 7/11/03. Statutory Authority:
					 RCW
					  43.70.040 and
					 chapter
					 70.170 RCW. 94-12-090,
					 § 246-455-001, filed 6/1/94, effective 7/2/94. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-455-001, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 84-20-067 (Order 84-06, Resolution No. 84-06), §
					 261-50-010, filed 10/1/84.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-020 - Reporting data set information

Current through Register Vol. 24-14, July 15, 2024
(1)
				Hospitals shall collect and report the following data set elements to the
				department:
(a) Patient control number:
				Patient's unique alpha-numeric number assigned by the hospital to facilitate
				retrieval of individual patient records;
(b) Patient medical record number;
(c) Type of bill;
(d) National Provider Identifier (UB-04), or
				department assigned identifier, as applicable;
(e) Patient last name;
(f) Patient first name;
(g) Patient middle initial;
(h) Patient Social Security number (at least
				the last four digits);
(i) Patient
				address;
(j) Patient zip code
				(U.S.A.);
(k) Patient country code
				(outside U.S.A.) International Organization for Standardization (ISO)
				3166-1;
(l) Patient's date of
				birth;
(m) Sex assigned at
				birth;
(n) Admission
				date;
(o) Type of
				admission;
(p) Admitting diagnosis
				code;
(q) Patient's ICD code (1-3)
				reason for visit;
(r) Point of
				origin for admission;
(s) Patient
				discharge status;
(t) Statement
				covers period (from - through);
(u)
				Revenue code;
(v) Units of
				service;
(w) Total
				charges;
(x) Payer identification
				(up to three): Payer identification number per the CHARS procedure manual
				identifying each payer group from which the hospital may expect some payment of
				the bill;
(y) Principal diagnosis
				code;
(z) Other diagnosis
				codes;
(aa) External cause of
				injury (ECI) code;
(bb) Principal
				procedure code;
(cc) Other
				procedure code;
(dd) Referring
				provider's National Provider Identifier (NPI), as applicable;
(ee) Attending provider's National Provider
				Identifier (NPI) according to Centers for Medicare and Medicaid Services (CMS)
				schedule;
(ff) Operating
				physician's National Provider Identifier (NPI) according to CMS schedule, as
				applicable;
(gg) Other provider's
				National Provider Identifier (NPI) according to CMS schedule, as
				applicable;
(hh) Admission
				hour;
(ii) Race - Until hospitals
				are required to report race consistent with WAC 246-455-025, race shall be
				reported per minimum office of management and budget (OMB) standards;
(jj) Ethnicity - Until hospitals are required
				to report ethnicity consistent with WAC 246-455-025, ethnicity shall be
				reported per minimum OMB standards;
(kk) Discharge hour;
(ll) Procedure date;
(mm) Present on admission status;
(nn) Health care provider taxonomy
				code;
(oo) Health care common
				procedure coding system (HCPCS);
(pp) Service date;
(qq) Facility federal tax number;
(rr) Insured last name, first name, middle
				name, suffix;
(ss) Patient's
				relationship to insured code;
(tt)
				Insured ID.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-025 - Reporting of additional patient demographic information

Current through Register Vol. 24-14, July 15, 2024
(1) In addition to the data elements required
				by WAC
				246-455-020,
				hospitals must collect additional information on patient's ethnicity, race,
				preferred language, disability, gender identity, and sexual orientation. When
				requesting demographic information under this section, hospitals must inform
				patients that providing the information is voluntary.
(2) Patient's ethnicity shall be identified
				by the patient and reported using one of the following categories:
(a) Hispanic, Latino/a, Latinx;
(b) Non-Hispanic, Latino/a, Latinx;
(c) Patient declined to respond; or
(d) Unknown to patient.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-040 - Acceptable media for submission of data

Current through Register Vol. 24-14, July 15, 2024
(1) A hospital shall submit data in the
				format prescribed by the department. The data must comply with the requirements
				in the
CHARS Procedure Manual
and
CHARS Companion
				Guide
. Additional information not listed in WAC
				246-455-020
				and 246-455-025 may be required by the department to successfully process data
				submission files. Copies of the
CHARS Procedure Manual
and
CHARS Companion Guide
may be obtained on the department's
				website or by contacting the department.
(2) A department designee shall submit data
				to the department in the format prescribed by the department.
Statutory Authority:
					 RCW
					  43.70.040 and
					 43.70.052. 07-09-091, §
					 246-455-040, filed 4/18/07, effective 5/23/07. Statutory Authority:
					 RCW
					  43.70.040 and [43.]70.170. 03-13-029, §
					 246-455-040, filed 6/10/03, effective 7/11/03. Statutory Authority:
					 RCW
					  43.70.040 and
					 chapter
					 70.170 RCW. 94-12-090,
					 § 246-455-040, filed 6/1/94, effective 7/2/94. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-455-040, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 88-16-043 (Order 88-05, Resolution No. 88-05), §
					 261-50-040, filed 7/29/88; 87-04-008 (Order 87-01, Resolution No. 87-01),
					 § 261-50-040, filed 1/23/87. Statutory Authority: RCW 70.39.180. 86-14-081
					 (Order 86-03, Resolution No. 86-03), § 261-50-040, filed 7/1/86; 85-17-020
					 (Order 85-05, Resolution No. 85-05), § 261-50-040, filed 8/13/85.
					 Statutory Authority: Chapter 70.39 RCW. 84-20-067 (Order 84-06, Resolution No.
					 84-06), § 261-50-040, filed
					 10/1/84.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-050 - Time deadline for submission of data

Current through Register Vol. 24-14, July 15, 2024
(1) A hospital shall submit data to the
				department or the department's designee within 45 calendar days following the
				end of each calendar month.
(2) The
				department designee shall submit the data to the department after receiving the
				data from the hospital in the time frame prescribed by the
				department.
Statutory Authority:
					 RCW
					  43.70.040 and
					 43.70.052. 07-09-091, §
					 246-455-050, filed 4/18/07, effective 5/23/07. Statutory Authority:
					 RCW
					  43.70.040 and
					 chapter
					 70.170 RCW. 94-12-090,
					 § 246-455-050, filed 6/1/94, effective 7/2/94. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-455-050, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 88-16-043 (Order 88-05, Resolution No. 88-05), §
					 261-50-050, filed 7/29/88; 87-04-008 (Order 87-01, Resolution No. 87-01),
					 § 261-50-050, filed 1/23/87; 84-20-067 (Order 84-06, Resolution No.
					 84-06), § 261-50-050, filed
					 10/1/84.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-060 - Edits to data

Current through Register Vol. 24-14, July 15, 2024
The department or the department's designee shall edit the
				  data as follows:
(1) Record layout
				compatibility edits on data submitted in accordance with WAC
				246-455-020
				and 246-455-025; and
(2)
				Verification of the data set elements set forth in WAC
				246-455-020
				and 246-455-025.
Statutory Authority:
					 RCW
					  43.70.040 and
					 chapter
					 70.170 RCW. 94-12-090,
					 § 246-455-060, filed 6/1/94, effective 7/2/94. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-455-060, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 88-16-043 (Order 88-05, Resolution No. 88-05), §
					 261-50-060, filed 7/29/88; 87-04-008 (Order 87-01, Resolution No. 87-01),
					 § 261-50-060, filed 1/23/87; 84-20-067 (Order 84-06, Resolution No.
					 84-06), § 261-50-060, filed
					 10/1/84.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-070 - Revisions to submitted data

Current through Register Vol. 24-14, July 15, 2024
(1) All
				data revisions required as a result of the edits performed pursuant to WAC
				246-455-060 shall
				be corrected by the hospital and returned to the department or the department's
				designee within 14 working days after the submission deadline in WAC
				246-455-050.
(2) The department's designee shall submit
				the data to the department after receiving the revised data from the hospital
				in the time frame prescribed by the department.
Statutory Authority:
					 RCW
					  43.70.040 and
					 chapter
					 70.170 RCW. 94-12-090,
					 § 246-455-070, filed 6/1/94, effective 7/2/94. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-455-070, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 RCW 70.39.180. 85-17-020 (Order 85-05, Resolution No. 85-05), §
					 261-50-065, filed 8/13/85. Statutory Authority: Chapter 70.39 RCW. 84-20-067
					 (Order 84-06, Resolution No. 84-06), § 261-50-065, filed
					 10/1/84.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-080

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					  43.70.040 and
					 43.70.052. 07-09-091, §
					 246-455-080, filed 4/18/07, effective 5/23/07. Statutory Authority:
					 RCW
					  43.70.040 and [43.]70.170. 03-13-029, §
					 246-455-080, filed 6/10/03, effective 7/11/03. Statutory Authority:
					 RCW
					  43.70.040 and
					 chapter
					 70.170 RCW. 94-12-090,
					 § 246-455-080, filed 6/1/94, effective 7/2/94. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-455-080, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 84-20-067 (Order 84-06, Resolution No. 84-06), §
					 261-50-070, filed 10/1/84.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-085 - Data files-Release of data files and data use agreements

Current through Register Vol. 24-14, July 15, 2024
(1) The department
				may create and release data files with patient discharge information as allowed
				under
				RCW
				 43.70.052 and this chapter. The type of
				information contained in the file, including direct and indirect patient
				identifiers, determines the category and permitted release of the data
				file.
(2) The department may
				aggregate data from patient discharge information, and may release such
				aggregated data with either direct patient identifiers or indirect patient
				identifiers, or both, in accordance with
				RCW
				 43.70.052 and this chapter.
(3) In order to maintain the confidentiality
				of patient discharge data, for individual requests for data the department in
				its discretion may designate any of the patient discharge data collected under
				RCW
				 43.70.052 and this chapter as either a direct
				patient identifier or an indirect patient identifier in addition to the
				elements already designated by the department in subsection (6) of this
				section.
(4) The department may
				distribute a data file with direct patient identifiers only to:
(a) Government agencies after entering into a
				data use agreement; or
(b)
				Researchers with approval from the Washington state institutional review board
				and a signed confidentiality agreement with the department.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-090

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					  43.70.040 and
					 43.70.052. 07-09-091, §
					 246-455-090, filed 4/18/07, effective 5/23/07. Statutory Authority:
					 RCW
					  43.70.040 and
					 chapter
					 70.170 RCW. 94-12-090,
					 § 246-455-090, filed 6/1/94, effective 7/2/94. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-455-090, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 87-08-037 (Order 87-02, Resolution No. 87-02), §
					 261-50-075, filed 3/30/87.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-100

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					  43.70.040 and [43.]70.170. 03-13-029, §
					 246-455-100, filed 6/10/03, effective 7/11/03. Statutory Authority:
					 RCW
					  43.70.040 and
					 chapter
					 70.170 RCW. 94-12-090,
					 § 246-455-100, filed 6/1/94, effective 7/2/94. Statutory Authority:
					 RCW
					  43.70.040. 91-02-049 (Order 121), recodified
					 as § 246-455-100, filed 12/27/90, effective 1/31/91. Statutory Authority:
					 Chapter 70.39 RCW. 88-16-043 (Order 88-05, Resolution No. 88-05), §
					 261-50-090, filed 7/29/88; 87-08-037 (Order 87-02, Resolution No. 87-02),
					 § 261-50-090, filed 3/30/87; 87-04-008 (Order 87-01, Resolution No.
					 87-01), § 261-50-090, filed 1/23/87. Statutory Authority: RCW 70.39.180.
					 86-14-081 (Order 86-03, Resolution No. 86-03), § 261-50-090, filed 7/1/86;
					 85-17-020 (Order 85-05, Resolution No. 85-05), § 261-50-090, filed
					 8/13/85.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-105 - Requests from government agencies for patient discharge data files containing direct patient identifiers

Current through Register Vol. 24-14, July 15, 2024
(1)
				A government agency requesting data files that contain direct patient
				identifiers for nonresearch purposes must comply with the requirement of
				RCW
				 43.70.052 and this section. The department
				will not release data to a government agency requesting data from the
				department pursuant to this section until all requirements of this section have
				been completed to the satisfaction of the department.
(2) A government agency submitting a data
				request under this section for nonresearch purposes must submit all of the
				following to the department in the form or format required by the department:
(a) A completed application on the form
				provided by the department;
(b) A
				signed data use agreement with the department that conforms with WAC
				246-455-400;
(c) All information
				required in subsection (3) of this section; and
(d) All fees required by WAC
				246-455-990.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-200 - Requests for patient discharge data files containing direct patient identifiers for research

Current through Register Vol. 24-14, July 15, 2024
(1) A
				researcher requesting data files that contains direct patient identifiers for
				research must comply with the requirements of
				RCW
				 43.70.052 and this section. The department
				will not release data to a researcher requesting data from the department until
				all the requirements of this section have been completed to the satisfaction of
				the department.
(2) A researcher
				submitting a data request under this section must submit all of the following
				to the department:
(a) A completed records
				request form associated with the human research review board application that
				contains all the information required in subsection (3) of this
				section;
(b) Approval from the
				human research review board of the research proposal for which the data is
				being requested;
(c) A signed
				confidentiality agreement with the department; and
(d) All fees required by WAC
				246-455-990.
Washington Administrative Code › Title 246 - Health, Department of › HEALTH INFORMATION › Chapter 246-455 - Hospital patient discharge information reporting › Section 246-455-300 - Requests from individuals or entities for patient discharge data files containing indirect patient identifiers

Current through Register Vol. 24-14, July 15, 2024
(1) All requests for data under this section
				must comply with the requirements of
				RCW
				 43.70.052 and this section. The department
				will not release data to an individual or entity requesting data from the
				department pursuant to this section until all the requirements of this section
				have been completed to the satisfaction of the department.
(2) The data released pursuant to this
				section will only be in the data file format prescribed by the
				department.
(3) An individual or
				entity submitting a data request under this section must submit all of the
				following on the form or in the format required by the department:
(a) A completed application on the form
				provided by the department;
(b) A
				signed data use agreement with the department that conforms with WAC
				246-455-400;
(c) All information
				required in subsection (4) of this section; and
(d) All fees required by WAC
				246-455-990.