WSR 17-13-046

[Filed June 14, 2017, 2:19 p.m.]

Effective Date: July 1, 2017.

Description: The health care authority (the agency) previously published notice of its intent to submit two medicaid state plan amendments (SPA) – 16-0027 for federally qualified health centers (FQHC) and 16-0028 for rural health centers (RHC) - under WSR 16-15-088. These SPAs were to be submitted as directed by the state legislature in E2SHB 2572 and as supported by the agency's center for medicare and medicaid innovation state innovation model grant. The agency delayed submission of these SPAs in order to work with FQHCs and RHCs to develop an alternative payment methodology. The agency has renumbered these SPAs and now intends to submit SPA 17-0014 regarding FQHCs and SPA 17-0015 regarding RHCs.

Both SPAs will establish an optional new alternative payment methodology (APM) for FQHCs (SPA 17-0014) and RHCs (SPA 17-0015). The new APM is intended to increase the use of value-based contracting, alternative quality contracting, and other payment incentives that promote quality, efficiency, cost-savings, and health improvement.

The APM will establish a budget-neutral, baseline per-member-per-month (PMPM) payment amount for each participating facility. PMPM payment amount will be applicable for medicaid managed care clients assigned to the facility by the managed care organization (MCO). MCOs will pay participating FQHCs and RHCs for each eligible client they assign to the facility, and the agency will pay enhancements to bring FQHCs and RHCs up to their baseline payment amounts, with adjustments for certain factors. The agency will perform reconciliations to ensure participating facilities receive no less than they would have under previous reimbursement methods. For both SPAs, the agency will ask the Centers for Medicare and Medicaid Services for an effective date of July 1, 2017.

The new APM is completely voluntary; FQHCs and RHCs will not be required to participate in the new APM if they do not wish to.

These SPAs are anticipated to have no effect on annual aggregate expenditures; participating facilities will receive no less than they would have under previous reimbursement methods.

The SPAs are in the development process; therefore copies are not yet available for review. To contact the agency for additional information and copies of the SPAs when they become available, please contact the agency in your county listed below, or the person listed below.

NOTE: Effective March 20, 2017, official public notice of proposed medicaid SPAs is published on the agency's web site at the Public Notices link. As a convenience, the agency will continue to publish copies of SPA notices in the Washington State Register.

Gary Swan, Healthier Washington Medicaid Transformation, 628 8th Avenue S.E., Olympia, WA 98501, phone (360) 725-1250, TDD/TTY 1-800-848-5429, fax (360) 586-9551, email gary.swan@hca.wa.gov, web site http://www.hca.wa.gov/hw/Pages/mt_initiative1.aspx.

Adams County Health Department

108 West Main

Ritzville, WA 99169

Phone (509) 659-3315

Clarkston Home and Community Services Office

525 Fifth Street

Clarkston, WA 99403

Web site http://www.altcwashington.com

Phone (509) 751-4672

Alt. Phone 1-800-310-4881

Fax (509) 758-4593

Tri-Cities Home and Community Services Office

500 North Morain Street

Suite 2210

Kennewick, WA 99336

Phone (509) 374-2100

Alt. Phone 1-800-310-4833

Fax (509) 374-7559

Chelan Community Services Office

805 South Mission Street

Wenatchee, WA 98801

Phone (509) 667-6000

Port Angeles Home and Community Services Office

235 West 1st Street

Port Angeles, WA 98362

Phone (360) 565-2160

Alt. Phone 1-800-280-9891

TTY (360) 417-5651

Fax (360) 417-1416

Vancouver Home and Community Services Office

800 N.E. 136th Avenue

Suite 220

Vancouver, WA 98684

Phone (360) 397-9500

Alt. Phone 1-800-280-0586

TTY (360) 750-4079

Fax (360) 992-7949

Aging and Disability Resource Center

410 East Main

Dayton, WA 99328

Web site http://www.altcwashington.com/

Phone (509) 382-4787

Kelso Home and Community Services Office

711 Vine Street

Kelso, WA 98626

Phone (360) 501-2500

Alt. Phone 1-800-605-7322

TTY (360) 577-7591

Fax (360) 578-4106

Wenatchee Home and Community Services Office

50 Simon Street S.E.

Suite B

East Wenatchee, WA 98802

Phone (509) 886-6140

Alt. Phone 1-800-670-8874

Fax (509) 886-6221

Republic Home and Community Services Office

89 East Delaware

Republic, WA 99166

Phone (509) 775-2227

Alt. Phone 1-888-437-0516

TTY (509) 775-2661

Fax (509) 775-2401

Franklin County Commissioners Office 

1016 North 4th Avenue

Pasco, WA 99301

Phone (509) 545-3535

Garfield County District Court

789 West Main Street

P.O. Box 817 or 819

Pomeroy, WA 99347

Phone (509) 843-1002

Moses Lake Home and Community Services Office

1651 South Pilgrim Street

Moses Lake, WA 98837

Phone (509) 764-5657

Alt. Phone 1-800-671-8902

TTY 1-800-833-6388

Fax (509) 764-5656

Aberdeen Home and Community Services Office

415 West Wishkah Street

Suite A2

Aberdeen, WA 98520

Phone (360) 533-9222

Alt. Phone 1-800-487-0119

TTY (360) 533-9730

Fax (360) 533-9782

Oak Harbor Home and Community Services Office

900 East College Way

Suite 210

Mt. Vernon, WA 98273

Phone (360) 429-2961

Alt. Phone 1-866-608-0836

Fax (360) 429-2958

Port Townsend Home and Community Services Office

915 Sheridan Street

Suite 201

Port Townsend, WA 98368

Phone (360) 379-4326

Alt. Phone 1-800-280-9991

Fax (360) 344-4600

King County Home and Community Services Office

1737 Airport Way South

Suite 130

P.O. Box 24847

Seattle, WA 98134

Phone (206) 341-7750

Alt. Phone 1-800-346-9257

TTY 1-800-833-6384

Bremerton Home and Community Services Office

4710 Auto Center Boulevard

Bremerton, WA 98312

Phone (360) 473-2299

Alt. Phone 1-800-422-7114

TTY (360) 478-4928

Fax (360) 478-6467

Ellensburg Home and Community Services Office

100 East Jackson Avenue

Suite 100

Ellensburg, WA 98926

Phone (509) 925-0433

Alt. Phone 1-800-310-4999

Fax (509) 962-7755

White Salmon Home and Community Services Office

221 North Main Street

White Salmon, WA 98672

Phone (509) 493-6157

Alt. Phone 1-800-504-1180

Chehalis Home and Community Services Office

3451 Galvin Road

Centralia, WA 98531

Phone (360) 807-7150

Alt. Phone 1-800-487-0360

Fax (360) 330-7552

Lincoln County Health Department

90 Nicholls Street

Davenport, WA 99122

Phone (509) 725-1001

Shelton Home and Community Services Office

2505 Olympic Highway North

Suite 440

Shelton, WA 98584

Phone (360) 664-9050

Alt. Phone 1-800-462-4957

Fax (360) 432-2045

Omak Home and Community Services Office

130 South Main

Omak, WA 98841

Phone (509) 846-2103

Alt. Phone 1-888-437-0529

TTY (509) 826-7389

Fax (509) 826-7439

South Bend Home and Community Services Office

307 East Robert Bush Drive

P.O. Box 87

South Bend, WA 98586

Phone (360) 875-4222

Alt. Phone 1-800-458-3747

Fax (360) 875-0590

Newport Home and Community Services Office

1600 West First Avenue

Newport, WA 99156

Phone (509) 447-6223

Alt. Phone 1-888-437-0516

Fax (509) 447-5256

Tacoma Home and Community Services Office

1949 South State Street

Tacoma, WA 98405

Phone (253) 476-7200

Alt. Phone 1-800-442-5129

TTY (253) 593-5471

Fax (253) 597-4161

San Juan County Health Services

145 Rhone Street

Friday Harbor, WA 98250

Phone (360) 378-4474

Fax (360) 378-7036

Mount Vernon Home and Community Services Office

900 East College Way

Suite 210

Mt. Vernon, WA 98273

Phone (360) 429-2961

Alt. Phone 1-866-608-0836

Fax (360) 416-7401

Stevenson Home and Community Services Office

266 S.W. Second Street

P.O. Box 817

Stevenson, WA 98648

Phone (509) 427-5611

Alt. Phone 1-800-505-4203

Fax (509) 427-4604

Smokey Point Home and Community Services Office

3906 172nd Street N.E.

Suite 101

Arlington, WA 98223

Phone (360) 651-6800

Alt. Phone 1-800-827-2984

Fax (360) 651-6832

Spokane Home and Community Services Office

1330 North Washington Street

Suite 3000

Spokane, WA 99201

Phone (509) 568-3700

Alt. Phone 1-800-459-0421

TTY (509) 568-3697

Fax (509) 568-3771

Colville Home and Community Services Office

1100 South Main

Colville, WA 99114

Phone (509) 685-5644

Alt. Phone 1-800-437-0516

Fax (509) 684-7430

Tumwater Home and Community Services Office

6639 Capitol Boulevard S.W.

Tumwater, WA 98512

Phone (360) 664-9050

Alt. Phone 1-800-462-4957

TTY (360) 407-1678

Fax (360) 664-9107

Health and Human Services

42 Elochoman Valley Road

Cathlamet, WA 98612

Phone (360) 795-8630

Alt. Phone 1-800-635-5989

Walla Walla Home and Community Services Office

206 West Poplar

Walla Walla, WA 99362

Phone (509) 524-4960

Alt. Phone 1-800-310-5678

Fax (509) 527-4142

Bellingham Home and Community Services Office

600 Lakeway Drive

Bellingham, WA 98225

Phone (360) 756-5750

Alt. Phone 1-800-239-8292

Fax (360) 676-2239

Colfax Home and Community Services Office

418 South Main Street

Suite 3

Colfax, WA 99111

Phone (509) 397-5091

Alt. Phone 1-800-459-0421

Fax (509) 397-4323

Yakima Home and Community Services Office

1002 North 16th Avenue

Yakima, WA 98902

Phone (509) 225-4400

Alt. Phone 1-800-822-2097

Fax (509) 575-2286