WSR 14-04-125
[Filed February 5, 2014, 9:05 a.m.]
Title or Subject: Primary care case management.
Effective Date: January 1, 2014.
Description: Medicaid State Plan Amendment (SPA) 14-0003.
Beginning January 1, 2014, the state of Washington began implementation of the Affordable Care Act (ACA), in part, by:
Expanding medicaid eligibility to individuals with a modified adjusted gross income up to one hundred thirty-eight percent of federal poverty level (FPL).
Enrolling newly eligible beneficiaries in apple health managed care.
Allowing enrollment of newly eligible American Indian/Alaska Native (AI/AN) beneficiaries in primary care case management (PCCM).
The health care authority (the agency) has already amended the medicaid state plan governing managed care to allow for this expansion. SPA 14-0003 will allow for enrollment of newly eligible AI/AN beneficiaries in the PCCM program. PCCM is provided by fourteen tribal clinics and two urban Indian centers.
PCCM is a case management program that provides coordination of care and referrals to specialty services for AI/AN beneficiaries. PCCM providers are paid a per member, per month fee to ensure case management and continuity of care for their patients. This program can be very beneficial to AI/AN who have chronic health conditions and who would see improved health outcomes from having their health care needs better coordinated.
The agency intends to submit this SPA on or before March 31, 2014.
For additional information, contact Alison Robbins, Division of Health Care Services, Quality and Care Management Section, 626 8th Avenue, P.O. Box 45530, Olympia, WA 98504, phone (360) 725-1634, TDD/TTY 1-800-848-5429, fax (360) 753-7315, e-mail