HCA upgrade of APR-DRG grouper version in ProviderOne

Washington State Health Care Authority sent this bulletin at 03/06/2018 01:49 PM PST

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Apple Health (Medicaid) Provider Alert

Attention Hospital Administrators:

As a reminder, the Washington State Health Care Authority (HCA) will upgrade the APR-DRG grouper version in ProviderOne, from 31 to 33. HCA will implement the updated grouper version 33 on April 1, 2018, for admission dates on or after April 1, 2018. The upgrade to APR-DRG version 33 is necessary because it is fully ICD-10 compliant.

HCA performed an analysis to determine the impacts of upgrading to ARP-DRG version 33. HCA’s analysis confirmed the following:

No algorithmic changes between APR-DRG grouper versions 31 and 33
No DRG weight changes between APR-DRG grouper version 31 and 33
No need to apply budget neutrality factors to APR-DRG version 33

About the Health Care Authority (HCA)

The Washington State Health Care Authority purchases health care for more than 2 million Washington residents through Apple Health (Medicaid) and the Public Employees Benefits Board (PEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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HCA upgrade of APR-DRG grouper version in ProviderOne

Apple Health (Medicaid) Provider Alert

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About the Health Care Authority (HCA)

Disclosure notice