November 2023 Provider News - Bonus Edition

Date: 11/07/23

In this issue:

General Updates - 15% Behavioral Health Agency Managed Care Rate Increase

______________________________________________________________________________________

General Updates

15% Behavioral Health Agency Managed Care Rate Increase

The 2023-2025 Washington State operating budget included a 15% increase effective January 1, 2024, for certain services paid through the behavioral health portion of the Managed Care capitation rates (as referenced services defined in the State’s Medicaid State Plan and the managed care contracts). In accordance with this increase, Coordinated Care will be updating our Behavioral Health Agency (BHA) Fee Schedule by 15%.

This communication is intended to provide some additional context on the rate increase and alert Coordinated Care providers on what they can expect and when. Behavioral Health providers who are currently reimbursed on our BHA fee schedule will receive this increase with no action needed, effective 1/1/2024.

Providers with alternative payment structures may require a contract update or amendment to implement the 15% increase. In those instances, a Coordinated Care network negotiator will contact those providers directly. The process may take some time, depending on a variety of factors, including the type of contract, provider type and system changes necessary to effectuate this change. We recognize these funds are critical, especially now during this workforce crisis so we are providing assurances that we will make all efforts to complete contract updates before the end of 2023.

Be aware, there may be some differences in how other MCOs pass these funds on to you.

For more information, see HCA's "Legislatively funded managed care rate increase" PDF.

Note that there are additional Medicaid fee schedule increases launching later in 2024 for designated professional services and primary care services. HCA will share additional information on the following items at a later date:

Professional services rate increase: July 1, 2024, effective date
Primary care rate increase: January 1, 2025, effective date

If you have questions, please reach out to Kate Mundell (Mary.Mundell@coordinatedcarehealth.com) and Jess Molberg (Jessica.L.Molberg@coordinatedcarehealth.com).