WSR 16-11-064

[Filed May 16, 2016, 7:17 a.m.]

Title or Subject: Medicaid State Plan Amendment 16-0005 - Supplemental Notice

Effective Date: July 1, 2016.

Description: The health care authority (the agency) previously published notice WSR 15-24-097 on January 5, 2016, to notify interested persons about the intent to submit medicaid state plan amendment (SPA) 16-0005 to add the new ground emergency medical transport (GEMT) program as mandated by HB 2007. That notice contained a start date of January 1, 2016, and inadvertently omitted the estimate for annual aggregate expenditure. The agency now anticipates initiating the GEMT program on or after July 1, 2016, and anticipates an approximate annual aggregate expenditure of $6,845,000 for state fiscal year 2017.

From WSR 15-24-097: 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 process; therefore a copy is not yet available. 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.