Washington State will continue Medicaid waiver for five more years

The Health Care Authority (HCA) is pleased to announce the Centers for Medicare & Medicaid Services (CMS) approved a renewal for our state’s Section 1115 Medicaid demonstration waiver. We call this waiver the Medicaid Transformation Project (MTP), and the MTP renewal “MTP 2.0.”

MTP 2.0 begins July 1, 2023.

What’s MTP and why renew it?

MTP is an agreement between HCA and CMS that allows our state to implement new policies and use federal Medicaid funds to improve Apple Health, Washington’s Medicaid program. Our current MTP demonstration ends June 30, 2023. MTP 2.0 will allow our 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, we proposed multiple changes to our existing MTP programs and proposed new ones. CMS approved most of these changes.

What does this mean?

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

More information

To learn more, read our approval letter from CMS. To learn more about MTP, visit the MTP website section.

*IMD stands for “institution for mental diseases.” IMDs are hospitals, nursing facilities, or other institutions of more than 16 beds that are primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, which includes SUD.

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Media contact

Please contact us at HCA Media Relations.