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Health Care Authority 2019
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12. December
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2018-12-18 10:00 AM - Commissioners' Agenda
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Health Care Authority 2019
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Last modified
12/13/2018 1:36:32 PM
Creation date
12/13/2018 1:33:30 PM
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Meeting
Date
12/18/2018
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
p
Item
Request to Approve a Contract with the Washington State Health Care Authority for Professional Services for Medicaid Administrative Claiming
Order
16
Placement
Consent Agenda
Row ID
50104
Type
Contract
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Vi. Any activities that are not directly related to the administration of the State Medicaid <br />plan. <br />d) Contribute to a quarterly SPMP report as needed by HCA and/or WSALPHO. Provide details <br />and additional information needed for the report as requested by HCA and/or WSALPHO , <br />within a mutually agreed upon time frame; <br />e) Participate in program planning and policy development meetings as requested by HCA; <br />The meetings will include discussions related to, but not limited to, reviewing the <br />SPMP reports and related topics or the effectiveness of the activities performed in <br />support of HCA's goals and the Medicaid State Plan. <br />f) Comply with any changes to the allowable SPMP activities as directed by the CMO; <br />Failure to comply with CMO directives may result in termination of SPMP participation <br />in the MAC program. <br />g) Monitor and ensure that all activities reimbursed at the seventy five percent (75%) <br />enhanced FFP are in support of the Medicaid State Plan and fall within the categories <br />below. All other allowable MAC activities performed by an SPMP are eligible for fifty <br />percent (50%) FFP; <br />h) Comply with any changes to allowable SPMP activities as directed by the CMO that <br />may include, but is not limited to: <br />Clinical consultation with medical providers regarding best practices and adequacy <br />of medical care covered by Medicaid. Includes, but is not limited to the following <br />areas: <br />(1) Pediatric immunization issues <br />(2) Access to Baby and Child Dentistry (ABCD) Emerging treatment/therapies for high <br />risk populations <br />ii. Coordination of Medicaid -covered medical services for medically at -risk populations. <br />(1) Medically fragile children <br />(2) High risk pregnant women <br />(3) Homeless individuals <br />(4) Individuals with multiple medical conditions <br />iii. Case staffing on the medical aspects of cases requiring Medicaid -covered services. <br />(1) Medically involved children in foster care <br />(2) High risk pregnant women <br />(3) Individual with communicable diseases requiring extraordinary/non-standard <br />medical care. <br />Local Health Jurisdiction Page 58 of 59 Medicaid Administrative Claiming <br />Washington State Health Care Authority Contract # K3069 <br />
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