Description: The health care authority (HCA) intends to submit medicaid SPA 21-0012 to implement policies and procedures that may be different from the policies and procedures otherwise applied under the medicaid state plan, during the period of the presidential and secretarial emergency declarations related to the COVID-19 outbreak. SPA 21-0012 allows Washington medicaid the flexibility to automatically enroll COVID-19 vaccine administration providers who have already completed medicare application processes for participation. SPA 21-0012 also allows Washington medicaid the flexibility to not require the servicing (rendering) provider National Provider Identifier for the administering of vaccines to medicaid recipients during the public health emergency.

This SPA is the preprint developed by the Centers for Medicare and Medicaid Services to waive or modify certain requirements of Titles XVIII, XIX, and XXI of the Act as a result of the consequences [of the] COVID-19 pandemic, to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the respective programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of such requirements as a result of the COVID-19 pandemic, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse.

At this time HCA is unable to determine the effect of SPA 21-0012 on the annual aggregate expenditures/reimbursement/payment for providers rendering professional services.

SPA 21-0012 is under development. HCA would appreciate any input or concerns regarding this SPA. To request a copy of the SPA when it becomes available or to submit comments, please contact the person named below (please note that all comments are subject to public review and disclosure, as are the names of those who comment).