PREPROPOSAL STATEMENT OF INQUIRY
Subject of Possible Rule Making: Trauma enhanced reimbursement.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 70.168.040 Emergency medical services and trauma care system trust account.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: (1) At present, current WAC 246-976-935 limits the trauma enhanced reimbursement payments to only services provided on the initial hospitalization. Those that perform necessary subsequent procedures do not receive reimbursement. It has been determined that some treatments of traumatic injuries are not possible at the time of initial hospitalization. Orthopedic injuries are good examples. As a result of these types of injuries, the physician responds with the trauma team, but may only evaluate and do palliative treatment because more life threatening procedures are a higher priority. It may be weeks or months later that a complex or staged orthopedic procedure is done.
(2) The emergency medical services and trauma care system trust account, RCW 70.168.040, was established to reimburse hospitals and health care providers for costs incurred while caring for uninsured or underinsured major trauma patients. Unlike the other parts of the trauma system (e.g. hospitals, physicians, and rehabilitation facilities), there is no language in current WAC 246-976-935 to allow prehospital verified agencies (i.e. health care providers), who respond to and transport major trauma patients which may be uninsured or underinsured, to get federal matching funds for transporting Medical Assistance Administration (MAA) patients.
By amending WAC 246-976-935 this would increase the amount of funds channeled into the Washington trauma system and allow for reimbursement to those entitled as intended by the legislature when the trust account was established.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The Department of Health, Office of Emergency Medical and Trauma Prevention (DOH, OEMTP) has and will continue to work in close conjunction with the Department of Social and Health Services, Medical Assistance Administration (DSHS, MAA). A liaison has been established between DOH, OEMTP and DSHS, MAA.
Process for Developing New Rule: Several statutory and other EMS and trauma care committees will participate in drafting, reviewing and commenting on the proposed rules through open public meetings and public workshops. These committees include constituents representing: Washington State Fire Commissioner's Association, Washington Ambulance Association, Washington State Firefighter's Association, Washington State Hospital Association, American College of Surgeons, Emergency Nurse's Association, Washington State Law Enforcement, Association of Neurological Surgeons, Washington State Medical Association Standards Committee, Washington State Association of Fire Chiefs, the public sector and the citizens of Washington state. In addition, we also involve constituents by mailing them the appropriate draft rules for their review and input inviting them to public WAC sessions, and by providing them with information on rules and updates at the appropriate meetings.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication. Open public meetings and public workshops will be held throughout the state and the final draft of the proposed WAC amended language will be sent out to all affected and interested parties before the formal public hearing is held.
Any questions or concerns regarding trauma enhanced reimbursement (WAC 246-976-935) should contact Dolly Fernandes, Prevention, Policy and Planning Manager, Office of Emergency Medical and Trauma Prevention, P.O. Box 47853, Olympia, WA 98504-7853, phone (360) 705-6718 or fax (360) 705-6706.
April 30, 2001
M. C. Selecky
Secretary