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AGO Opinions with Topic: RATES
AGO 1983 No. 26 >  November 23, 1983
OFFICES AND OFFICERS - STATE - HOSPITAL COMMISSION - HOSPITALS - RATES
AUTHORITY OF HOSPITAL COMMISSION TO ESTABLISH BILLING SYSTEMS FOR REGULATED HOSPITALS (1) The Washington State Hospital Commission is not authorized to require hospitals to provide it with data involving diagnosis, procedures, age and sex of patients, total charges and file tracer numbers, unrelated to any currently authorized function or activity of the commission.(2) The Hospital Commission may not, under current law, require hospitals to bill their patients and/or payors on the basis of prospective fixed charges for a particular treatment as opposed to charges based on actual goods and services rendered.(3) The Hospital Commission may not, under current law, require all payors, including health care contractors, indemnity insurance carriers, and self-insured or private payors, to reimburse hospitals on the basis of prospective fixed charges for a particular treatment as opposed to charges based on actual goods and services rendered.(4) Assuming a system of reimbursement based upon prospective fixed charges for a particular treatment, the Hospital Commission may not, under current law, permit a hospital to retain excess revenues generated as a result of cost efficient practices by the hospital.
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