WSR 25-04-081
HEALTH CARE AUTHORITY
[Filed February 3, 2025, 8:51 a.m.]
NOTICE
Title or Subject: Medicaid State Plan Amendment (SPA) 25-0008 Alternative Benefit Plan Updates.
Effective Date: April 1, 2025.
Description: The health care authority (HCA) intends to submit SPA 25-0008 to bring the alternative benefit plan (ABP) into alignment with the medicaid state plan. ABP is the plan by which Washington expanded medicaid coverage to people ages 19 through 64 with income at or below 133 percent of the federal poverty level as allowed by the Affordable Care Act. ABPs are aligned with the medicaid state plan regarding service coverage and must be updated to reflect changes made to that plan. SPA 25-0008 updates ABP to reflect the following changes that have already been made to the medicaid state plan:
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| • | Add coverage of nonroutine ACIP-recommended vaccines and vaccine administration as described in Section 1905 (a)(13)(B) of the Social Security Act. |
| • | Add birth doulas, behavioral health support specialists, certified community health aide providers, community health workers, licensed advance social worker associates, licensed independent clinical social worker associates, licensed marriage and family therapist associates, licensed mental health counselor associates, and substance use disorder professionals. |
Please note that additional information may be added to the ABP as medicaid SPAs are approved prior to the submission of SPA 25-0008.
Washington ensures compliance with [42 C.F.R.] § 440.345 related to full access to EPSDT services, and the method for complying with the provisions of Section 5006(e) of the American Recovery and Reinvestment Act of 2009.
SPA 25-0008 is an administrative action to bring ABP into alignment with the medicaid state plan. Therefore, it is anticipated to have no effect on the annual aggregate expenditures/reimbursement/payment for professional services.
SPA 25-0008 is in the development process; therefore, a copy is not yet available for review. HCA would appreciate any input or concerns regarding this SPA. To request a copy 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 Ann Myers, State Plan Coordinator, 626 8th Avenue S.E., Olympia, WA 98501, phone 360-622-1978, TRS 711, email ann.myers@hca.wa.gov.