Update on Legislative action for Apple Health (Medicaid) Community Health Workers (CHW) benefit

Washington State Health Care Authority sent this bulletin at 04/12/2024 08:00 AM PDT

April 12, 2024

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Update on Legislative action for Apple Health (Medicaid) Community Health Workers (CHW) benefit

This bulletin addresses frequently asked questions from providers about the status of an Apple Health (Medicaid) Community Health Worker (CHW) benefit and reimbursement for CHW services.

CHW services frequently asked questions

Does Apple Health currently reimburse CHW services?

Apple Health does not currently reimburse for CHW services outside of First Steps Maternity Support Services (MSS) and Federally Qualified Health Centers (FQHC).

What happened during the Legislative session regarding Apple Health reimbursement for CHW?

There was language and funding reflected in the Legislature’s 2024 supplemental budget for the Health Care Authority (HCA) to extend the CHW grant until June 30, 2025 and implement an Apple Health CHW benefit.

What happens next?

HCA will use the feedback gathered from community presentations in 2023 informing approaches for implementing an Apple Health CHW benefit. HCA will work with federal, state, and community partners to develop and implement the CHW benefit.

This is anticipated to take about a year with a goal of having reimbursement accessible by July 1, 2025. This work will include development of the reimbursement rate under the Apple Health program.

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About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

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.