Description: The health care authority (HCA) intends to submit SPA 23-0047 as a technical correction to add coverage of and reimbursement for DHAT. In accordance with SB 5079, signed into law on February 22, 2017, HCA submitted SPA 17-0027 on August 22, 2017, to add DHAT coverage; the Centers for Medicare and Medicaid Services (CMS) disapproved that SPA. In Washington State Health Care Authority v. Centers for Medicare & Medicaid Services, Case No. 21-70338, the United States Court of Appeals for the Ninth Circuit, held that CMS's disapproval of SPA 17-0027 was not in accordance with law. Therefore, CMS approved SPA 17-0027 on June 21, 2023, with an effective date of July 23, 2017.

In HCA's original notice filed as WSR 17-15-114, it was estimated that SPA 17-0027 may increase annual aggregate expenditures by an average of $525,000 for dental services within the DHAT scope of practice, including oral examinations, preventive dental services, simple restorations, stainless steel crowns, extractions, and X-rays. However, SPA 17-0027 was expected to have no impact on the state portion of annual aggregate expenditures as the services authorized by this SPA will be eligible for 100 percent federal medical assistance participation under Section 1905 of the Social Security Act.

A copy of SPA 23-0047 is available for review. HCA would appreciate any input or concerns regarding this SPA. To request a copy of the SPA or 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).