WSR 16-12-045

[Filed May 25, 2016, 1:59 p.m.]

Title or Subject: Medicaid State Plan Amendment (SPA) 16-0012.

Effective Date: January 1, 2017.

Description: The health care authority (HCA) intends to submit medicaid SPA 16-0012 in order to create a special family planning only benefit package. This family planning only benefit package will cover limited family planning and family planning-related services for women and men who are currently covered by HCA's two waiver programs - family planning only extension and take charge. These two programs are currently authorized through an 1115 demonstration waiver that expires December 31, 2016. Effective January 1, 2017, HCA intends to transition all clients currently enrolled in these two programs into the new family planning only program. Beginning on January 1, 2017, new clients will be able to apply and enroll in the new program by completing a paper application and submitting it to HCA.

The benefit package for the new family planning only program will be the same as the two programs it replaces. The family planning services covered include: All FDA-approved contraceptives; natural family planning; over-the-counter contraception; emergency contraception; sterilization; contraceptive education, counseling, and management; STI/STD testing and treatment related to family planning visits; cervical cancer screening according to national clinical guidelines when associated with a family planning visit; office visits; and limited ancillary services related to the above services.

The eligibility criteria will match the income and household composition (medical assistance unit) standards for the modified adjusted gross income-based apple health for pregnant women program, which adds one to the standard household size. The take charge program, which this is replacing, had a higher income threshold but did not add one to the standard household size. Taking into account the differences in eligibility criteria, there will be no change in the eligible population.

Because services will remain the same, this SPA is anticipated to have no effect on annual aggregate expenditures.

The SPA is in the development process; therefore a copy is not yet available for review. To contact the agency for additional information and a copy of the SPA when it becomes available, please contact Anaya Balter, Family Planning Program Manager, P.O. Box 45530, Olympia, WA 98504-5530, phone (360) 725-1652, TDD/TTY 1-800-848-5429, fax (360) 725-1152, e-mail familyplanning@hca.wa.gov, web site www.hca.wa.gov.