WSR 19-23-094
[Filed November 20, 2019, 9:48 a.m.]
Title or Subject: Medicaid State Plan Amendment (SPA) 20-0001 Update Managed Care.
Effective Date: January 1, 2020.
Description: The health care authority (the agency) intends to submit SPA 20-0001 to reflect the final implementation of the integration of mental health and substance use disorder services (collectively known as "behavioral health") into an integrated managed care (IMC) program under contract with apple health managed care organizations (MCO). SPA 20-0001 also updates the IMC section of the state plan to make technical corrections and more clearly reflect that the following medicaid services are currently covered by the IMC program:
Inpatient hospital services.
Outpatient hospital services.
Oral health examinations and services.
On January 1, 2020, the agency will implement IMC in the Thurston-Mason, Great Rivers, and Salish regional service areas (RSA). The RSAs consist of Clallam, Cowlitz, Grays Harbor, Jefferson, Kitsap, Lewis, Mason, Pacific, Thurston, and Wahkiakum counties. Coverage previously provided by behavioral health organizations under the 1915(b) behavioral health waiver for specialty behavioral health services will be transferred to MCOs across all regions of the state.
SPA 20-0001 is expected to have no effect on the annual aggregate expenditures, reimbursement, or payment for MCOs.
A copy of SPA 20-0001 is in development. The agency would appreciate any input or concerns regarding this SPA. To request a copy of the SPA when I [it] is available and 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 Jessica Diaz, Managed Care Programs, 626 8th Avenue S.E., Olympia, WA 98504, phone 360-725-1177, TRS (TDD/TTY) 711, fax 360-664-0261, email