WSR 14-05-028

[Filed February 10, 2014, 3:50 p.m.]

Title or Subject: Apple health managed care program.

Effective Date: January 1, 2014.

Description: Medicaid State Plan Amendment 14-0004.

Beginning January 1, 2014, the state of Washington will implement portions 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 the federal poverty level (FPL).

The health care authority intends to mandatorily enroll newly eligible medicaid beneficiaries in apple health managed care (formerly healthy options) beginning with January 1, 2014, enrollment. We anticipate an addition of approximately 239,000 newly eligible medicaid clients by the end of 2014, many of whom will enroll in managed care. Apple health managed care provides full scope medical benefits, as well as mental health services and care coordination for program enrollees with chronic health care conditions.

To allow mandatory enrollment of clients in the expansion population, the agency intends to submit 1932(a) SPA 14-0004 to the Centers for Medicare and Medicaid Services, adding the medicaid expansion population to Washington's apple health managed care program as a mandatory eligibility group.

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 Alison.Robbins@hca.wa.gov.