WA: Department of Health, Health Care Authority prepare for potential shutdown

OLYMPIA — The Department of Health (DOH) and the Health Care Authority sent out notices to stakeholders providing an overview of the impact a government shutdown would have on agency operations. DOH’s full notice is included below:

With little time remaining in the state’s current two-year budget cycle, the Legislature has yet to reach agreement on operating and capital budgets for the next two years. Governor Inslee continues to work with House and Senate budget negotiators and leadership to achieve a final budget compromise before the conclusion of the second special session on June 28.

If the operating and capital budgets are not enacted by June 30, agencies will have to implement full or partial shutdowns. Agencies have been working with the Washington State Office of Financial Management to develop contingency plans for government operations in the still-unlikely event a shutdown must be implemented.

If there is a state government shutdown, the Department of Health will be significantly impacted. The following health profession and health care facility regulatory services, including those pending on June 30, will not continue until the agency reopens:

›Acceptance, review or issuance of applications for new health professions credentials.
› Issuance of renewal of health profession credentials – however, the Secretary of Health will grant an administrative modification that extends the duration of those licenses, certifications, or registrations for all health profession credentials that would normally expire during the period of the shutdown.
› Acceptance or review of applications for Certificate of Need.
› Ongoing investigations and disciplinary actions for health care providers.
› Inspections and ongoing investigations for health care facilities.
› Acceptance and investigation of new complaints about health care providers or health care facilities – however, during the period of the shutdown there will be very limited monitoring of complaints about health care providers or facilities and only those involving risk of imminent harm may be investigated.

Although we remain hopeful a shutdown will not occur, we want you to be fully aware of the potential impacts to our important work.

The Health Care Authority’s notice, included in full here, states:

Our intent is to continue covering services for Medicaid and Children’s Health Insurance Program (CHIP) clients as well as [Public Employee Benefits Board] members, retirees, and dependents. PEBB benefits are paid through non-appropriated fund sources and we expect our contracted PEBB plans to continue paying for services. Although we will be unable to pay Medicaid and CHIP fee-for-service providers or finalize premium payments for Medicaid managed care until a budget is passed, our expectation is that fee-for-service providers and Medicaid health plans will continue those services for now. ProviderOne will remain operative for normal billing functions during this interim, including eligibility checks and payments for dates-of-service prior to July 1.

Additionally, we will reduce our staffing level to a small number of employees to keep major systems operational. This will eliminate customer service for Medicaid and PEBB. For Medicaid-related non-pharmaceutical services that require prior authorization but are medically necessary to prevent loss of limb or life, prior authorization will be waived. To bill for a service meeting this criteria, please clearly state in the comment field of the claim form “emergent/urgent service.” Services that are not necessary to prevent loss of limb or life but normally require prior authorization need to be delayed until the budget is resolved.