HEALTH CARE AUTHORITY

[Filed September 1, 2021, 1:58 p.m.]

Title or Subject: Medicaid State Plan Amendment (SPA) 21-0030 - Psychiatric Long-Term Civil Commitment Payment.

Effective Date: October 1, 2021.

Description: The health care authority (HCA) intends to submit medicaid SPA 21-0030 regarding payment for services provided for psychiatric long-term civil commitments. Under this SPA, medicare and medicaid pay for specific "allowed" services at specific "allowed" payment rates; these rates may differ. HCA will pay up to the higher allowed payment for services provided for psychiatric long-term civil commitments when the claim is for an allowed service(s) and paid for by both medicare and medicaid. The total medicare and medicaid payments cannot exceed HCA's medicaid payment rate, using the per diem method that would have applied if the claim had been paid by medicaid alone. The change is expected to increase average expenditures per claim of $39,000. HCA is making this change to better account for the increased costs for long-term psychiatric care.

SPA 21-0030 is expected to increase the annual aggregate expenditures/reimbursement/payment for long-term inpatient psychiatric services by $1,437,543 annually.

A copy of SPA 21-0030 is available for review. HCA would appreciate any input or concerns regarding this SPA. To request a copy of the SPA 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).

CONTACT: Abby Frazier-Cole, Financial Services, 626 8th Avenue S.E., Olympia, WA 98504, phone 360-725-1835, TRS 711, email abby.frazier-cole@hca.wa.gov.