A Washington state agency that covers healthcare costs for Medicaid patients and has the power to audit providers receiving those funds has stayed largely dormant as allegations of patient safety issues in the state's psychiatric hospitals have increased, a Seattle Times investigation found.
The Washington State Health Care Authority has agreements with psychiatric hospitals in the state that participate in Medicaid that allow it to conduct audits, but it hasn't conducted any since at least 2014, officials told the Times.
Thought the agency has received several complaints, officials said that none of them warranted an audit. Community Health Plan of Washington, an insurer providing health services for Medicaid patients, grew concerned about practices at Smokey Point Behavioral Hospital in Marysville, Wash., in part due to an investigation by the Times published in August. The health plan put a temporary hold on sending patients to Smokey Point and complained to the Washington State Health Care Authority, the state agency it works for.
The state health care authority directed five health plans to conduct on-site visits at Smokey Point after the August investigation by the Times, and then said the health plans were "for the most part satisfied with the care that was being provided," MaryAnne Lindeblad, the authority's Medicaid director, told the Times.
A complaint was made by King County officials to the authority in April about its concerns with requests to detain patients who checked in voluntarily at BHC Fairfax Hospital in Kirkland, Wash. The authority referred the complaint to the state health department, where it has remained open since, the Times reports.
Authority officials told the Times that there isn't a protocol to inform the state Medicaid agency about patient safety violations found by the state health department and CMS.
"It certainly appears that we have a place in our system that we need to do an improvement," said Ms. Lindeblad to the Times. "You've raised an issue to us that we are going to solve."