Health Care Authority’s webinar on Medicaid enrollment changes aims to address key hospital questions

The Health Care Authority (HCA) is planning significant changes to Apple Health enrollment. Under a new policy effective April 1, 2016, enrollees will be retroactively assigned to a managed care plan as of the beginning of the month the patient is enrolled, rather than at the beginning of the month following enrollment.  HCA will be hosting a webinar on March 17, from 2:00- 3:00 p.m. to provide information regarding the changes and answer questions. WSHA recommends that hospital staff involved in Medicaid patient enrollment and managed care plan prior authorization participate in the webinar.Please click here for the HCA webcast invitation and webinar registration link.

WSHA staff earlier met with HCA staff to express our concerns with this policy and additional burdens it might place on hospitals if they are unable to get payment from the plan the patient is assigned to because the identity of the plan and its prior authorization or notification requirements are unknown at the time of service. HCA indicated it is requiring the managed care plans to adjust their prior authorization and/or admission notification requirements for these situations to minimize burden and risk for providers but we do not know the details on how the various plans will accomplish this.

If you have specific questions, concerns or examples of cases you wish HCA to consider, we recommend you submit them in advance to HCA at hcamcprograms@hca.wa.gov.   Please copy Andrew Busz at andrewb@wsha.org on your correspondence with HCA so we can keep track of issues and the HCA responses.