HCA Plan in Case of Partial Shutdown of State Services
The Washington State Health Care Authority (HCA) provides the following information on their website regarding state agency operations in the case that the Washington State Legislature does not pass the 2017-2019 budget before July 1, 2017.
If the Legislature does not pass the 2017-19 budget before July 1, 2017, state agencies will be required to suspend operations. HCA is hopeful that the budget will be enacted before the end of the fiscal year, but we need to plan ahead so that our customers and partners have the information they need.
Our intent is to continue covering services for Washington Apple Health (Medicaid) clients and Public Employees Benefits Board (PEBB) Program members.
Medicaid and CHIP
- Although we would be unable to pay Medicaid and CHIP fee-for-service providers or finalize premium payments for Medicaid managed care until a budget is passed, our expectation is that fee-for-service providers and Medicaid health plans will continue those services.
- You should see no change for clients covered under Medicaid managed care plans. The managed care plans would remain fully operational, and you should conduct business with them as usual.
- ProviderOne would remain operative for normal billing functions during this interim, including eligibility checks and payments for dates-of-service prior to July 1.
- For non-pharmaceutical services that require prior authorization but are medically necessary to prevent loss of limb or life, prior authorization will be waived. To bill for a service meeting this criteria, please clearly state in the comment field of the claim form “emergent/urgent service.” Services that are not necessary to prevent loss of limb or life but normally require prior authorization need to be delayed until the budget is resolved.
- No customer service support would be available for Medicaid clients.
- We expect our contracted PEBB Program plans to continue paying for services.
- No customer service support would be available for PEBB Program members.
- PEBB member FAQ
HCA Director Dorothy Frost Teeter and HCA Chief Medical Officer Dr. Dan Lessler have sent the following information: