INTERPRETIVE OR POLICY STATEMENT
SOCIAL AND HEALTH SERVICES
Subject: Medicaid State Plan Amendment 03-019 approved by CMS.
Effective Date: August 11, 2003.
Document Description: The Department of Social and Health Services (department), Medical Assistance Administration (MAA), has updated the Medicaid state plan to further describe: (1) Service programs described in Attachments 3.1-A and 3.1-B to the plan; and (2) payment methods used to pay for service programs that are described in Attachment 4.19-B of the plan. These revisions found in State Plan Amendment (SPA) 03-019 were approved by CMS on November 3, 2004 with an effective date of August 11, 2003.
These updates clarify some service programs and their payment methods that already exist in the state plan and describe some service programs and their payment methods not previously identified in the Medicaid state plan. The department currently administers all programs described, and has for some time. These updates are made to identify and/or clarify all service programs administered by MAA in the department. Clarifying language exists for most Medicaid services with significant changes for the following service programs:
* Attachment 3.1-A, categorically needy services.
** Attachment 3.1-B, medically needy services.
*** Attachment 4.19-B, other institutional and noninstitutional services payment methods.
| • | Inpatient Hospital*, ** |
| • | Outpatient Hospital *, **, $ |
| • | Freestanding Ambulatory Surgery Centers *, **, $ |
| • | Freestanding Birthing Centers *, **, $ |
| • | Freestanding Alcohol/Drug Treatment Centers *, **, $ |
| • | Indian Health Services and Tribal Facilities *, **, $ |
| • | Rural Health Clinics *, **, $ |
| • | Federally Qualified Health Centers (FQHCs) *, **, $ |
| • | Laboratory Services *, ** |
| • | Radiology Services *, ** |
| • | Nursing Facilities for Clients Under Age 21 *, ** |
| • | Early Periodic Screening, Diagnosis, and Treatment (EPSDT)*,** |
| • | Physicians Services *, ** |
| • | Medical Care & Other Remedial Care *, **, $ |
| • | Medical Nutrition and Medical Nutrition Therapy *, **, $ |
| • | Home Health Care *, ** |
| • | Private Duty Nursing *, **, $ |
| • | Clinic Services *, **, $ |
| • | Dental Services *, **, |
| • | Physical Therapy, Occupational Therapy, Services for speech, hearing, language disorders *, **, $ |
| • | Dentures *, **, $ |
| • | Prosthetic Devices *, **, $ |
| • | Eyeglasses *, **, $ |
| • | Diagnostic Services *, ** |
| • | Intermediate Care Facilities/Skilled Nursing Facilities *, ** |
| • | Inpatient Psychiatric Care for Clients under 21 years *, **, $ |
| • | Nurse Mid-wife Services *, **, $ |
| • | Non-nurse Mid-wife Services *, **, $ |
| • | Hospice *, ** |
| • | Extended Services for Pregnant Women ** |
| • | Respiratory Care *, ** |
| • | Transortation [Transportation]*, **, $ |
| • | Interpreter Services *, **, $ |
| • | Planned Home Births *, **, $ |
For more information regarding this clarification of language and justification for the payment methods, please write to Larry Linn, Rates Analysis Section, Medical Assistance Administration, Department of Social and Health Services, P.O. Box 45510, Olympia, WA 98504-5510.
To receive a copy of the interpretive or policy statement, contact Ann Myers, Department of Social and Health Services, Medical Assistance Administration, Division of Policy and Analysis, P.O. Box 45533, Olympia, WA 98504, phone (360) 725-1345, weblink http://maa.dshs.wa.gov, TDD (800) 848-5429, fax (360) 586-9727, e-mail Myersea@dshs.wa.gov.
December 20, 2004
Ann Myers
Manager