WSR 13-19-099

[Filed September 18, 2013, 9:53 a.m.]

Title or Subject: Medicaid State Plan Amendments (SPAs) 13-36 and 13-37 Full Encounter Rate Payment by Managed Care Plans.

Effective Date: Upon approval by Centers for Medicare and Medicaid Services (CMS).

Description: Due to legislative action, the health care authority is submitting medicaid SPAs 13-36 and 13-37 to change the method of reimbursing federally qualified health centers (FQHCs) (in SPA 13-36) and rural health centers (RHCs) (in SPA 13-37) for their managed care clients. Instead of HCA paying the monthly enhancements to the FQHCs and RHCs for their managed care clients, the managed care plans will pay the FQHCs and RHCs at each clinic's full encounter rate. There are no expected changes to expenditures as a result of this change; it is intended to be budget-neutral. This change in payment mechanism will take effect upon approval by CMS.

For additional information, contact Jean Bui, Professional Rates, P.O. Box 45510, Olympia, WA 98504, phone (360) 725-1973, TDD/TTY 800-848-5429, fax (360) 753-9152, e-mail jean.bui@hca.wa.gov.