WSR 14-05-043

[Filed February 13, 2014, 3:14 p.m.]

Title or Subject: Medicaid State Plan Amendment (SPA) 14-0013.

Effective Date: October 1, 2014.

Description: Third party recovery.

The health care authority (the agency) intends to submit SPA 14-0013 to revise the treatment questionnaire (TQ) process. TQs are generated based on ICD-9 accident-related diagnosis codes within the range of 800 to 999. Certain diagnosis codes within that range are not active in the ProviderOne payment system because there is no recovery potential. Because states will start using ICD-10 diagnosis codes within the next year, the agency intends to list the excluded diagnosis codes in the state plan, making the transition to ICD-10 easier.

In addition, SPA 14-0013 will reflect the practice of no longer sending out third notices or ask [asking] the community service offices (CSOs) to sanction clients for noncooperation (not responding to the TQs).

There is no anticipated increase or decrease in annual aggregate expenditures.

For additional information, contact Kathy Fertuna, Coordination of Benefits, Casualty Unit, P.O. Box 45561, Olympia, WA 98504-5561, (360) 725-1195, TDD/TTY 1-800-848-5229, fax (360) 753-3077, e-mail fertuke@hca.wa.gov.