WSR 23-05-094
HEALTH CARE AUTHORITY
[Filed February 15, 2023, 9:05 a.m.]
NOTICE
Title or Subject: Medicaid State Plan Amendments (SPAs) 23-0012 and 23-0013 Community Behavioral Support Services.
Effective Date: July 1, 2023.
Description: The health care authority (HCA) intends to submit medicaid SPAs 23-0012 and 23-0013 to amend the 1915(i) section of the medicaid state plan for home and community-based service benefits regarding behavioral health personal care (BHPC). The new community behavioral health support services (CBHS) will be implemented as a covered medicaid benefit if approved by the Centers for Medicare and Medicaid Services (CMS).
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| • | SPA 23-0012 will amend the financial eligibility for individuals seeking CBHS to disregard income equal to the difference between 150 percent of the federal poverty level and 300 percent of the federal benefit rate. |
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| • | SPA 23-0013 will amend Attachment 3.1-F Part 2 to add CBHS to the list of benefits that the managed care organizations (MCOs) are responsible for when the client is in managed care. |
SPAs 23-0012 and 23-0013 are being submitted at the request of CMS to accompany SPA 22-0007, which has been submitted to CMS to amend Washington's 1915(i) section of the medicaid state plan for home and community-based service benefits regarding BHPC, in compliance with legislative direction. HCA filed notice of its intent to submit SPA 22-0007 under WSR 22-01-142.
SPAs 23-0012 and 23-0013 are expected to increase the annual aggregate cost/payment for CBHS, which includes protective oversight and supervision and direct skill development or restoration. HCA will set rates to be paid for these new services in both the managed care and fee-for-service delivery models. HCA will utilize its established rate-setting methodologies. The costs/payments associated with these new services will increase because HCA forecasts an increase in the number of clients eligible for these services. However, specific data is not currently available.
SPAs 23-0012 and 23-0013 are in the development process. To request a copy when they become 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).
CONTACT: SPA 23-0012: Paige Lewis, paige.lewis@hca.wa.gov; SPA 23-0013: Jessica Diaz, Jessica.diaz@hca.wa.gov; Medicaid Programs Division, 626 8th Avenue S.E., Olympia, WA 98501, TRS 711.