The provisions of RCW 70.39.140 et seq., under which hospital rates and related matters are regulated by the state hospital commission, are applicable to hospitals maintained and operated by public hospital districts formed under chapter 70.44 RCW.
(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.
Explanation of the legal relationship between the budget and rate‑making functions of the commissioners of a public hospital district and the statutory review functions of the state hospital commission under chapter 70.39 RCW; procedures to be followed by a public hospital district in establishing budgets and fixing rates, and in obtaining review and approval thereof from the state hospital commission; necessity for further action by a public hospital district commission following approval or disapproval of its proposed rates or budget by the hospital commission; effect of a rate increase made by a public hospital district which is later disapproved by the state hospital commission.
The Washington state hospital commission has the authority, under RCW 70.39.140, to devise and approve the use of alternative systems of payment to hospitals for services provided to health care recipients covered under Medicare, Medicaid, Industrial Insurance or similar programs which the payors under those programs may then, in the exercise of their legal authority, require such hospitals to utilize.