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Action Needed if Receiving MCO Payments

Action Needed
‎ if You’re Receiving MCO Payments

Action Needed

If you are caring for a resident currently receiving behavioral health personal care (BHPC) MCO wraparound funding through a Managed Care Organization (MCO) – you need to take action. This funding will soon transition to Community Behavioral Health Supports (CBHS)-Supportive Supervision on July 1, 2024

To continue to get paid for your eligible resident(s) after July 1, 2024, you will need to have a contract with the Health Care Authority (HCA) and the resident’s assigned MCO.

About This Change

The state is transitioning BHPC to a new program called Community Behavioral Health Supports (CBHS). CBHS services will be authorized and paid for by the Health Care Authority (HCA) for the Fee for Service (FFS) population or Managed Care Organizations (MCO) for Medicaid Managed Care members.

Most clients currently approved for BHPC MCO funding will qualify for the new service called “Supportive Supervision”.

Beginning July 1, 2024, Home and Community Services (HCS) will no longer have authority to authorize or pay for BHPC in a residential facility for:

  • Any new residents, and
  • Current residents during the implementation year (July 2024-June 2025) once the residents’ annual CARE assessment is completed. This means if a current resident is receiving BHPC, and their CARE assessment is due in November 2024, the provider will continue to have BHPC authorized and paid through HCS until November 2024. If eligible for CBHS service authorization and payment will transition to HCA/MCO on December 1, 2024.

Webinar Recordings

Recordings and presentation slides from recent trainings that will walk you through the Core Provider Agreement and Contracting processes are available below:

Contact the Health Care Authority for help with completing the Core Provider Agreement and contracting with MCOs at: hca1915iservices@hca.wa.gov

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