WSR 16-10-090
[Filed May 3, 2016, 2:57 p.m.]
Title or Subject: Medicaid State Plan Amendment 16-0016 Apple Health Managed Care.
Effective Date: July 1, 2016.
Description: The health care authority (HCA) intends to submit Apple Health Managed Care State Plan Amendment (AHMC/SPA) Number 16-0016 to:
Move Klickitat 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. Two MCOs are under contract with the agency to provide AHMC in Klickitat County on April 1, 2016: Community Health Plan of Washington and Amerigroup. Molina Healthcare of Washington will begin serving Klickitat County on July 1, 2016. As a result, Klickitat County no longer meets the requirements for the "voluntary" enrollment designation.
Amend the description of the enrollment process and related sections in the state plan to reflect the agency's new "earlier enrollment" policy for clients who are newly eligible for medicaid. Beginning on April 1, newly eligible medicaid clients are enrolled into a managed care plan effective the first of the month in which he or she becomes eligible. The previous policy was to enroll new clients into a managed care plan effective the first of the month AFTER he or she became eligible. This policy change affects not only AHMC but also the fully integrated managed care (FIMC) program in southwest Washington.
Add substance use disorder providers to the list of critical providers in Section K of the SPA.
A copy of the draft SPA is available on request. To contact the agency for additional information and a copy of the SPA, please contact Alison Robbins, HCA, 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