WSR 22-10-049
HEALTH CARE AUTHORITY
[Filed April 28, 2022, 2:45 p.m.]
NOTICE
Title or Subject: Medicaid State Plan Amendment (SPA) 22-0006 Primary Care Case Management - Entities (PCCMe).
Effective Date: July 1, 2022.
Description: The health care authority (HCA) intends to submit Medicaid SPA 22-0006 in order to implement a new PCCMe program for American Indian and Alaska Native medicaid beneficiaries. This program will expand options for Indian health care providers (IHCPs) looking to provide and be adequately reimbursed for provision of the following limited case management benefits:
1. Provision of intensive telephonic case management.
2. Provision of face-to-face case management.
3. Development of enrollee care plans.
4. Provision of enrollee outreach and education activities.
5. Operation of a customer service call center.
6. Implementation of quality improvement activities including administering enrollee satisfaction surveys or collecting data necessary for performance measurement of providers.
7. Coordination with behavioral health systems/providers.
8. Coordination with long-term services and supports systems/providers.
SPA 22-0006 is expected to increase the annual aggregate reimbursement to IHCPs who elect to participate in the PCCMe program. The Washington state legislature appropriated $3,000,000 for this program starting in state fiscal year (SFY) 2023. The program is anticipated be fully implemented in SFY 2025, with an appropriation of $46,000,000.
A draft of SPA 22-0006 is available for review at https://www.hca.wa.gov/about-hca/tribal-affairs/primary-care-case-management-entities-pccme-state-plan-amendment. HCA would appreciate any input or concerns regarding this SPA. To request a copy of the SPA 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: Lena Nachand, Office of Tribal Affairs, 686 8th Avenue S.E., Olympia, WA 98501, phone 360-725-1386, TRS 711, fax 360-586-9551, email lena.nachand@hca.wa.gov, website https://www.hca.wa.gov/about-hca/tribal-affairs.