Rulemaking for Mental Health Assessment for Young Children

Washington State Health Care Authority sent this bulletin at 07/08/2022 08:00 AM PDT

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Rulemaking for Mental Health Assessment for Young Children

The Health Care Authority (HCA) filed a notice of permanent rule adoption (or CR-103P) of WAC 182-531-1400 on May 11, 2022, to support implementation of policy changes related to mental health assessment of young children made by 2SHB1325 (2021). The rule amendment added the following language to WAC 182-531-1400(9)(a):

(ii) For clients five years of age and younger, the agency pays for the following without requiring prior authorization:

(A) Up to five sessions to complete a psychiatric diagnostic evaluation; and

(B) Evaluations in the home or community setting, including reimbursement for provider travel.

These rules went into effect on June 12, 2022. To read the filing notice and view the permanent rules, see WSR 22-11-028.

To learn more about HCA’s rulemaking process, visit our rulemaking webpage.

For more information about mental health assessments for young children, visit HCA’s Mental Health Assessment for Young Children provider webpage.

What’s next?

HCA and Department of Health (DOH) recognize the current language included in WAC 246-341-0640 requires justification of diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and currently does not include reference to the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-5™). HCA and DOH are partnering to update WAC 246-341-0640 to ensure alignment across HCA and DOH rules and guidance.

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About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.