Description: The health care authority (HCA) previously filed notice under WSR 23-23-149 of the intent to submit three SPAs (24-0001, 24-0002, and 24-0003) and a 1915(i) waiver amendment to add community behavioral health support (CBHS) services. CBHS services will include two services intended to better support the needs of individuals with complex behavioral health needs in long-term settings: Skills development and restoration, and supportive supervision and oversight.

SPA 24-0002 will update the medicaid state plan managed care table so CBHS services can be provided either fee-for-service or within managed care. In addition, HCA is taking the opportunity to update this section of the medicaid state plan to align with changes that have been made to the other licensed practitioners section of the state plan in Attachment 3.1-A, section 6.d. HCA will add the following practitioners to the list of managed care practitioners: Podiatrists, optometrists, pharmacists, pharmacy interns, pharmacy technicians, lead behavior analysts, licensed assistant behavior analysts, and substance use disorder professionals and trainees, formerly known as certified chemical dependency professionals and trainees. The Center for Medicare and Medicaid Services (CMS) approved the addition of these practitioners in previous SPAs.

The SPA is expected to increase the annual aggregate cost/payment for CBHS services. HCA will utilize its established rate setting methodologies to set rates to be paid for these new services in both the managed care and fee-for-service delivery models. 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.

SPA 24-0002 is under development. To request a copy of SPA 24-0002 when it becomes available 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.

CONTACT: Jessica Diaz, Medicaid Program Division, 626 8th Street S.E., Mailstop 45530, Olympia, WA 98501, phone 360-725-1177, TRS 711, email jessica.diaz@hca.wa.gov, website https://hca.wa.gov.