RCW 71.24.885
Medicaid rate increases—Review authority—Reporting.
(1) It is the intent of the legislature that behavioral health medicaid rate increases be grounded with the rate-setting process for the provider type or practice setting.
(2) In implementing a rate increase funded by the legislature, including rate increases provided through managed care organizations, the authority must work with the actuaries responsible for establishing medicaid rates for behavioral health services and managed care organizations responsible for distributing funds to behavioral health services to assure that appropriate adjustments are made to the wraparound with intensive services case rate, as well as any other behavioral health services in which a case rate is used.
(3)(a) The authority shall establish a process for verifying that funds appropriated in the omnibus operating appropriations act for targeted behavioral health provider rate increases, including rate increases provided through managed care organizations, are used for the objectives stated in the appropriation.
(b) The process must: (i) Establish which behavioral health provider types the funds are intended for; (ii) include transparency and accountability mechanisms to demonstrate that appropriated funds for targeted behavioral health provider rate increases are passed through, in the manner intended, to the behavioral health providers who are the subject of the funds appropriated for targeted behavioral health provider rate increases; (iii) include actuarial information provided to managed care organizations to ensure the funds directed to behavioral health providers have been appropriately allocated and accounted for; and (iv) include the participation of managed care organizations, behavioral health administrative services organizations, providers, and provider networks that are the subject of the targeted behavioral health provider rate increases. The process must include a method for determining if the funds have increased access to the behavioral health services offered by the behavioral health providers who are the subject of the targeted provider rate increases.
(c) The process may:
(i) Include a quantitative method for determining if the funds have increased access to behavioral health services offered by the behavioral health providers who received the targeted provider rate increases;
(ii) Ensure the viability of pass-through payments in a capitated rate methodology; and
(iii) Ensure that medicaid rate increases account for the impact of value-based contracting on provider reimbursements and implementations of pass-through payments.
(4) By November 1st of each year, the authority shall report to the committees of the legislature with jurisdiction over behavioral health issues and fiscal matters regarding the established process for each appropriation for a targeted behavioral health provider rate increase, whether the funds were passed through in accordance with the appropriation language, and any information about increased access to behavioral health services associated with the appropriation. The reporting requirement for each appropriation for a targeted behavioral health provider rate increase shall continue for two years following the specific appropriation.
[ 2020 c 285 § 1.]
Structure Revised Code of Washington
Chapter 71.24 - Community Behavioral Health Services Act.
71.24.015 - Legislative intent—Community behavioral health system.
71.24.030 - Grants, purchasing of services, for community behavioral health programs.
71.24.035 - Director's powers and duties as state behavioral health authority.
71.24.045 - Behavioral health administrative services organization powers and duties.
71.24.062 - Psychiatry consultation line—Implementation.
71.24.063 - Partnership access lines—Psychiatric consultation lines—Data collection.
71.24.064 - Partnership access lines—Psychiatric consultation lines—Funding—Performance measures.
71.24.067 - Partnership access lines—Psychiatric consultation lines—Review.
71.24.068 - Telebehavioral health access account.
71.24.115 - Recovery navigator programs—Reports.
71.24.125 - Grant program—Treatment services—Regional access standards.
71.24.135 - Expanded recovery support services program—Regional expanded recovery plans.
71.24.160 - Proof as to uses made of state funds—Use of maintenance of effort funds.
71.24.200 - Expenditures of county funds subject to county fiscal laws.
71.24.215 - Sliding-scale fee schedules for clients receiving behavioral health services.
71.24.220 - State grants may be withheld for noncompliance with chapter or related rules.
71.24.250 - Behavioral health administrative services organizations—Receipt of gifts and grants.
71.24.260 - Waiver of postgraduate educational requirements—Mental health professionals.
71.24.350 - Behavioral health ombuds office.
71.24.370 - Behavioral health services contracts—Limitation on state liability.
71.24.380 - Purchase of behavioral health services—Managed care contracting—Requirements.
71.24.383 - Managed care organization contracting—Requirements.
71.24.400 - Streamlining delivery system—Finding.
71.24.405 - Streamlining delivery system.
71.24.415 - Streamlining delivery system—Authority duties to achieve outcomes.
71.24.430 - Coordination of services for behavioral health clients—Collaborative service delivery.
71.24.435 - Behavioral health system—Improvement strategy.
71.24.450 - Offenders with mental illnesses—Findings and intent.
71.24.455 - Offenders with mental illnesses—Contracts for specialized access and services.
71.24.460 - Offenders with mental illnesses—Report to legislature.
71.24.510 - Integrated comprehensive screening and assessment process—Implementation.
71.24.520 - Substance use disorder program authority.
71.24.525 - Agreements authorized under the interlocal cooperation act.
71.24.530 - Local funding and donative funding requirements—Facilities, plans, programs.
71.24.535 - Duties of authority.
71.24.545 - Comprehensive program for treatment—Regional facilities.
71.24.555 - Liquor taxes and profits—City and county eligibility conditioned.
71.24.560 - Opioid treatment programs—Pregnant individuals—Information and education.
71.24.565 - Acceptance for approved treatment—Rules.
71.24.570 - Emergency service patrol—Establishment—Rules.
71.24.575 - Criminal laws limitations.
71.24.580 - Criminal justice treatment account.
71.24.585 - Opioid and substance use disorder treatment—State response.
71.24.589 - Substance use disorders—Law enforcement assisted diversion—Pilot project.
71.24.594 - Opioid overdose reversal medications—Education—Distribution—Labeling—Liability.
71.24.597 - Opioid overdose reversal medication—Coordinated purchasing and distribution.
71.24.598 - Drug overdose response team.
71.24.599 - Opioid use disorder—City and county jails—Funding.
71.24.605 - Fetal alcohol screening and assessment services.
71.24.610 - Interagency agreement on fetal alcohol exposure programs.
71.24.615 - Chemical dependency treatment expenditures—Prioritization.
71.24.625 - Uniform application of chapter—Training for designated crisis responders.
71.24.640 - Standards for certification or licensure of evaluation and treatment facilities.
71.24.645 - Standards for certification or licensure of crisis stabilization units.
71.24.647 - Standards for certification or licensure of triage facilities.
71.24.649 - Standards for certification or licensure of mental health peer-run respite centers.
71.24.650 - Standards for certification or licensure of a clubhouse.
71.24.660 - Recovery residences—Referrals by licensed or certified service providers.
71.24.710 - Reentry services—Work group.
71.24.715 - Reentry services—Waiver application.
71.24.720 - Less restrictive alternative treatment—Transition teams.
71.24.850 - Regional service areas—Report—Managed care integration.
71.24.855 - Finding—Intent—State hospitals.
71.24.861 - Behavioral health system coordination committee.
71.24.870 - Behavioral health services—Adoption of rules—Audit.
71.24.885 - Medicaid rate increases—Review authority—Reporting.
71.24.893 - National 988 system—Crisis response improvement strategy steering committee.
71.24.894 - National 988 system—Department reporting—Audit.
71.24.896 - National 988 system—Duties owed to public—Independent contractors.
71.24.898 - National 988 system—Technical and operational plan.