WSR 22-08-058
[Filed April 4, 2022, 6:40 a.m.]
Title or Subject: Medicaid State Plan Amendment (SPA) 22-0011 Alternative Benefit Plan Updates.
Effective Date: July 1, 2022.
Description: The health care authority (HCA) intends to submit medicaid SPA 22-0007 to bring the alternative benefit plan (ABP) into alignment with the medicaid state plan. The ABP is the plan by which Washington expanded medicaid coverage to people ages 19 through 64 with income at or below 133 percent of the federal poverty level as allowed by the Affordable Care Act. ABPs are aligned with the medicaid state plan regarding service coverage and must be updated to reflect changes made to that plan. SPA 22-0007 updates the ABP to reflect the following changes that have already been made to the medicaid state plan:
Adds collaborative care.
Adds licensed emergency medical service providers.
Add applied behavioral therapy for adults.
Add social worker services for home health.
Adds coverage for client participation in qualifying clinical trials.
Replaces outdated terms (e.g., "alcohol abuse," "chemical dependency," etc.) with updated terms (e.g., "substance use disorder," "behavioral health," etc.).
Adds medication assisted treatment.
Adds substance use disorder peer support.
Adds medical withdrawal management (previously detoxification).
Adds additional dental services for oral health connections.
Add school-based health care services.
Please note that additional information may be added to the ABP as medicaid SPAs are approved prior to the submission of SPA 22-0011.
SPA 22-0011 is an administrative action to bring the ABP into alignment with the medicaid state plan. Therefore, it is anticipated to have no effect on the annual aggregate expenditures/reimbursement/ payment for professional services.
SPA 22-0011 is in the development process; therefore, a copy is not yet available for review. HCA would appreciate any input or concerns regarding this SPA. To request a copy when it becomes available 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: Josh Morse, Health Services, 626 8th Avenue S.E., Olympia, WA 98501, phone 360-725-0839, TRS 711, fax 360-725-2641, email