WSR 15-24-097

[Filed December 1, 2015, 8:13 a.m.]

Title or Subject: Medicaid State Plan Amendment 16-0005.

Effective Date: January 1, 2016.

Description: The health care authority (the agency) intends to submit medicaid state plan amendment (SPA) 16-0005 [in] order to add the ground emergency medical transport (GEMT) program as mandated by HB 2007. The purpose of the GEMT program is to provide a supplemental payment to qualifying publicly owned or operated ground emergency transportation providers.

Participation in GEMT program is voluntary. To qualify for the supplemental payment, a ground ambulance provider must:

1. Provide GEMT services to medicaid fee-for-service (FFS) enrollees or medicaid managed care (MC) enrollees; and

2. Be owned or operated by a state, city, or county fire protection district, community services district, health care district, federally recognized Indian tribe, or any unit of government as defined in 42 C.F.R. Sec. 433.50.

For FFS enrollees, the agency will fund the supplemental payments through a certified public expenditures program. The funding for increased MC payments will be provided through intergovernmental transfers program. The supplemental payments, combined with other sources of reimbursement from the agency, will not exceed the actual costs of providing the services.

This SPA is in the development process; therefore a copy is not yet available for review. To contact the agency for additional information and a copy of the SPA when it becomes available, please contact Jean Bui, Section Manager, Rates Development, 626 8th Avenue S.E., Olympia, WA 98501, phone (360) 725-1973, TDD/TTY 1-800-848-5429, fax (253) 350-6512, e-mail jean.bui@hca.wa.gov, web site http://www.hca.wa.gov/medicaid.