WSR 16-14-023

[Filed June 27, 2016, 10:03 a.m.]

Title or Subject: Medicaid State Plan Amendment (SPA) 16-0029 Recovery Audit Contractors.

Effective Date: July 21, 2016.

Description: Section 6411(a) of the Affordable Care Act expanded the recovery audit contractor (RAC) program to medicaid and requires each state medicaid program to establish an RAC program, absent an exception, to enable the auditing of claims for services furnished by medicaid providers.

The health care authority (the agency) intends to submit medicaid SPA 16-0029 in order to request a full exception to the federal requirement for an RAC. The agency believes it has appropriate resources in place to identify and recover improper payments related to medicaid fraud, waste and abuse.

The agency anticipates SPA 16-0029 to have no effect on annual aggregate expenditures.

The 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 Lisa DeLaVergne, Program Integrity, 626 8th Avenue S.E., Olympia, WA 98501, phone (360) 725-1705, TDD/TTY 1-800-848-5429, fax (360) 586-0212, e-mail lisa.delavergne@hca.wa.gov, web site www.hca.wa.gov/medicaid/pi.