Washington state extends Medicaid waiver for five more years

Editor’s note: Last March the Quad published a story about Medicaid recertification requirements in Washington state for the 3,210 Okanogan County residents covered by or eligible for Medicaid (Apple Health) coverage. The following media release from the state Health Care Authority (HCA) explains the latest development in the state program.

OLYMPIA – On June 30, the Health Care Authority (HCA) announced that the Centers for Medicare & Medicaid Services (CMS) approved a renewal for Washington state’s Section 1115 Medicaid demonstration waiver. This waiver is called the Medicaid Transformation Project (MTP). The MTP renewal is MTP 2.0 and began July 1, 2023.

MTP is an agreement between HCA and CMS that allows Washington state to implement new policies and use federal Medicaid funds to improve Apple Health, Washington’s Medicaid program. The current MTP demonstration ends June 30, 2023. MTP 2.0 will allow the state to continue to develop innovative projects, activities, and services that benefit Apple Health (Medicaid) enrollees.

Last summer, HCA and the Department of Social and Health Services (DSHS) applied to renew MTP. In the MTP 2.0 application, the state proposed multiple changes to its existing MTP programs and proposed new ones. CMS approved most of these changes.

Programs approved to continue:

• Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA), which:
  • Expands care options for older people so they can stay at home and delay or avoid more intensive services, such as moving to a nursing facility.
  • Assists unpaid family caregivers, ages 18 or older, who provide care for their loved ones.
• Substance use disorder (SUD) and institution for mental diseases (IMD) supports.
• Supportive housing and supported employment.

Newly approved programs:

• Continuous Apple Health enrollment for children, ages 0-5.
• Apple Health postpartum coverage expansion.
• Contingency management for SUD treatment.
• Re-entry coverage for individuals leaving a prison, jail, or youth correctional facility.
• Program innovations that support older adults, including expanded eligibility and presumptive eligibility to support access and enrollment.
• Programs that address health-related social needs (HRSN), including:
  • Community-based workforce payment through Community Hubs and the Native Hub.
  • HRSN services (e.g., nutrition, housing, medical respite, transportation).
  • Rental subsidies for up to six months.

Programs pending (discussions/negotiations for these programs will continue past July 1, 2023):

• Re-entry coverage for individuals leaving IMDs/state hospitals.
• Rental subsidies (beyond six months).
• Program innovations that support older adults through coordinated personal care, guardianship and decision-making supports.
• Washington Integrated Care Assessment (WA-ICA).
• Funding for the development of local, community-based initiatives in support of health equity.

Programs denied:

CMS denied the request for postpartum care for non-citizens. The denial does not mean Washington State cannot implement this program; it only means it cannot use MTP waiver funds to support this program. The state will be using state funding to provide postpartum care for individuals who are not U.S. citizens.

To learn more visit hca.wa.gov online.