June 12, 2012
ADSA: AFH #2012-010
Managed Medical Care Program
Dear Adult Family Home Provider:
The purpose of this letter is to inform you that Washington Health Care Authority (HCA) will be requiring most Medicaid-only blind/disabled Supplemental Security Income (SSI) residents to enroll in a managed medical care program. Examples of Medicaid only blind/disabled SSI residents not required to enroll are those who are over 65 years old, or those who have Medicare coverage. Washington HCA is making the change to improve care, reduce costs, expand service delivery options and implement payment reform and quality control features authorized by the Legislature.
Eligible Medicaid residents living in your home should receive a letter from HCA notifying them of this change. These residents will be assigned a health plan beginning July 1, 2012. The enrollment date depends on where residents live.
- For those living in Eastern Washington, enrollment begins July 1, 2012.
- For those living in Western Washington (except King and Pierce counties), enrollment begins August 1, 2012 and for King and Pierce Counties, enrollment begins September 1, 2012.
Prior to enrolling, residents who wish to continue care with their current doctor, specialist, or hospital will need to verify that these care providers accept their health plan. Please assist your residents with this issue as needed.
For more information, visit the HCA website https://www.hca.wa.gov/billers-providers-partners/programs-and-services/managed-care and for questions, please contact Medicaid at 1-800-562-3022.
Sincerely,
Joyce Pashley Stockwell, Director
Residential Care Services