Family Planning Only demonstration waiver extended by 1 year

Washington State Health Care Authority sent this bulletin at 06/28/2024 09:00 AM PDT

June 28, 2024

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Family Planning Only demonstration waiver extended by 1 year

The current Family Planning Only (FPO) 1115 demonstration waiver has been extended by 1 year while the Centers for Medicare and Medicaid Services (CMS) continues to process applications for the five-year demonstration renewal. The 1115 FPO waiver has been extended through June 30, 2025.

What is Family Planning Only?

FPO provides coverage for eligible populations to receive a comprehensive preventative family planning visit each year and any related family planning follow-up visits.

Covered benefits also include:

Sexual and reproductive health counseling, education, or risk reduction
Education and supplies for all Food and Drug Administration (FDA) approved contraceptives, natural family planning, or abstinence
Permanent methods such as tubal sterilizations or vasectomies
Cervical cancer screenings
Sexual transmitted infection (STI) screening and testing (including hepatitis C and HIV) and the human papillomavirus (HPV) and hepatitis B vaccines

More information

Eligibility

Eligibility for FPO is different from Washington’s Medicaid. FPO’s income eligibility is higher at 260% of federal poverty, and FPO can be utilized by those who are covered by other insurance yet seeking confidential family planning services. Immigration status does not affect eligibility.

For client information, see the Family Planning Only client webpage.

Brochures

To promote the coverage opportunity, see our Family Planning Only brochures translated into 15 languages. Email Andrea Estes If you’d like to request a bulk shipment of printed copies (including translated versions).

For provider information, see the Family Planning Only provider webpage.

Family Planning Only technical assistance

The Health Care Authority (HCA) family planning team will host office hours twice annually to help with FPO program questions, feedback, and guidance.

The next office hours session will be Tuesday, September 10, 2024 at 12:45 p.m. Visit the FPO provider web page to register.

Contact

Contact Medical Assistance Customer Service Center (MACSC) for questions related to:

Billing and claims
Service card requests
Apple Health (Medicaid) health plan enrollments
Benefit questions
Technical issues with ProviderOne (providers only)

Email family planning for urgent family planning or FPO policy questions.

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.