The Washington State Health Care Authority and Department of Social and Health Services (DSHS) are consolidating Medicaid, medical and other selected payments into a single provider payment system called ProviderOne – currently processing more than $5 billion annually in payments for Medicaid services.
Health Care Authority, DSHS announce Provider Compensation Subsystem and Services vendor
The second phase of the project – known as “Phase 2” – will expand payment processing to include social service providers such as community residential providers, home care agencies, and medical providers that did not transition in the first phase of the project.
In May 2012, the Washington State Legislature reinstated funding for Phase 2 and the project team re-started efforts to transition approximately 6,500 social service providers and 40,000 individual providers represented by Service Employees International Union 775NW into ProviderOne.
Phase 2 will be implemented in two groups, depending on the provider tax type (1099 or W-2 tax forms):
- Adult Day Health (ADH)
- Adult Family Homes
- Alternative Living
- Assisted Living Facilities
- Companion Homes
- Durable Medical Equipment
- Group Homes/Group Training Homes
- Home Care Agencies
- Home Delivered Meals
- Licensed Staff Residential
- Mental and Physical Incapacity Evaluations
- Nurse Delegation
- Personal Emergency Response System
- Physical, Occupational, Speech Therapy; Counseling
- Private Duty Nursing
- Skilled Nursing
- Supported Living
Implementation for 1099 providers is scheduled for 2014. (Detailed dates to be announced.) Currently, the project team is in the development phase and refining staff and readiness plans. The visual below shows the current progress.
- Individual Providers represented by Service Employees International Union Healthcare 775NW
The Health Care Authority conducted a separate procurement for a Provider Compensation Subsystem and Services vendor to implement a modern payroll system for W-2 providers that meets the requirements of the collective Bargaining Agreement with Service Employees International Union Healthcare 775NW and the Office of Inspector General. The Provider Compensation Subsystem and Services system and ProviderOne will share data as needed to meet business needs. By sharing this data, all Medicaid payments will be consolidated into a single data repository.
All Phase 2 providers will receive communications, training, and support to prepare for billing through ProviderOne.