Health Care Authority (HCA) Medical Assistance Programs

Revised May 2, 2013

Frequently used links to the main Medicaid agency (Health Care Authority) by Long-term care field staff

Medical Assistance/Information Links

• Medical Assistance programs in EAZ
• Health Care Authority (HCA) internet (Main Medicaid Agency)
• Eligibility for Medical Programs (internet HCA description of medical programs including medical standards)

Medical Assistance-Coverage

• Medication Coverage Lists including over the counter items
• Durable Medical Equipment
• Scope of care chart
  

Medical Assistance Administrative Hearing Rules

• Administrative Hearing rules for Medical Services

Managed Care Information

• Managed Care (Including information on WMIP project)
• Healthy Options and Long-term care
• Managed Care Information for clients and providers-Health Care Authority
• Managed Care Medical Programs - includes link to the Healthy Options Medical Benefit Book
• Healthy Options and Long-term care
• Health Care Authority Nursing Facility Provider Billing Guide
• ProviderOne Billing and Resource Guide (includes provider notices)
• Washington State Medicaid Help Desk   (toll-free number and e-mail link for customers and providers)
• Online request for medical service card replacement
• Health Care Authority Smarter Track Mailbox for internal Provider One manual updates
• mmishelp@hca.wa.gov

When to use mmishelp@hca.wa.gov:  Situation:  Client gets discharged from a NF and cannot get a prescription filled because of the coding.

Prior to P1, we would e-mail Fran Smiley for these types of fixes and she would update MMIS manually.

 

In the P1 world, we need to e-mail DSHS HRSA MMIS Smarter Track when needing a manual fix in the system.  This includes when we are correct an incorrect date of death in ACES.  Once the case is closed in ACES, any fix must be manually sent over to MMIS smarter track to match ACES data

Health Care Authority Medicare Buy-in issues: 

• Field staff use Barcode tickler 102@MBU
• For clients, contact the Medicaid Customer Service Center 1-800-562-3022