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WAC 296-23A-0520: How does the department pay for high outlier cases?


Published: 2015

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WACs > Title 296 > Chapter 296-23A > Section 296-23A-0520











296-23A-0500    

296-23A-0530







No agency filings affecting this section since 2003







WAC 296-23A-0520









How does the department pay for high outlier cases?









Cases defined as high cost outliers will be reimbursed at the diagnosis-related-group (DRG) payment rate plus one hundred percent of costs in excess of the threshold. Costs are determined by multiplying the allowed charges by the hospital specific percent of allowed charges (POAC) factor.
[Statutory Authority: RCW 51.04.020, 51.04.030 and 51.36.080. WSR 97-06-066, § 296-23A-0520, filed 2/28/97, effective 4/1/97.]