Description: The health care authority (HCA) intends to submit SPA 24-0012 to add substance use disorder professionals (SUDPs) and mental health therapists/social workers licensed as associates to section 6.d Other Licensed Practitioners of the medicaid state plan. Currently, SUDPs may provide services only through behavioral health agencies (BHAs) per section 13.d Rehabilitative Services of the medicaid state plan. SUDP services are not reimbursed by medicaid in other non-BHA settings. This SPA will allow these provider types to be reimbursed for services provided to medicaid enrollees in other practice settings. Additionally, adding licensed mental health counselor associates, licensed marriage and family associates, licensed independent clinical social workers associates, and advanced social worker associates as medicaid providers will allow them to provide and bill for services that are within their scope of practice while under appropriate supervision.

HCA expects SPA 24-0012 could potentially increase annual aggregate expenditures/payments for fiscal year 2026 for SUDPs up to $702,362 for services provided by SUDPs in settings other than BHAs.

HCA expects SPA 24-0012 could potentially increase annual aggregate expenditures/payments for fiscal year 2026 up to $596,152 for services provided by licensed mental health counselor associates, licensed marriage and family associates, licensed independent clinical social worker associates, and advanced social worker associates.

A draft of SPA 24-0012 is available for review. HCA would appreciate any input or concerns regarding this SPA. To request a copy or submit comments, you may 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). Please submit comments no later than March 4, 2024.