WSR 16-06-056
[Filed February 25, 2016, 7:27 a.m.]
Title or Subject: Medicaid State Plan Amendment - Apple Health Managed Care.
Effective Date: April 1, 2016.
Description: The agency intends to submit medicaid state plan amendment (SPA) 16-0007 to:
Move Skamania County from "voluntary" to "mandatory" with respect to enrollment of various populations into apple health managed care.
Counties are considered "voluntary" for enrollment if (a) they have only one contracted managed care organization (MCO) or (b) there are two or more contracted MCOs but, together, they do not provide adequate capacity to serve medicaid-eligible clients in that county. Skamania County is part of the two county southwest Washington regional service area (with Clark County), in which the fully integrated managed care (FIMC) program will be implemented on April 1, 2016. Two MCOs are under contract with the agency to provide FIMC on April 1, 2016: Community health plan of Washington and Molina Healthcare of Washington. As a result, Skamania County no longer meets the requirements for the "voluntary" enrollment designation.
Move the "SSI and SSI-related aged populations age sixty-five or older" medicaid-only population from "excluded" to "voluntary" with respect to enrollment into apple health managed care.
Correct the current SPA by removing "American Indian/Alaska Natives" from the list of "Excluded Groups"; "American Indian/Alaska Natives" are already "voluntary" with respect to enrollment into apple health managed care.
A copy of the SPA is available upon request. To contact the agency for additional information and a copy of the SPA, please contact Alison Robbins, Health Care Authority, Managed Care Programs, 626 8th Avenue S.E., P.O. Box 45530, Olympia, WA 98501, phone (360) 725-1634, TDD/TTY 1-800-848-5429, fax (360) 753-7315, e-mail