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MTP renewal

The Health Care Authority (HCA) is pursuing a renewal for Washington State’s Section 1115 Medicaid demonstration waiver, called the Medicaid Transformation Project (MTP). MTP ends December 31, 2021.

Under a renewal, we will continue MTP initiatives and activities, which are supporting people and communities across our state. An MTP renewal will:

  • Support our efforts in addressing health-related social needs, health equity, whole-person care, and paying for health and value in Washington State.
  • Help us continue long-term services and supports (LTSS, also called Initiative 2) and Foundational Community Supports (FCS, also called Initiative 3) programs.
  • Enhance federal funding for some mental health and substance use disorder residential treatment stays (for Initiative 4 and Initiative 5).
  • Create several new initiatives, including enhanced coverage and services for incarcerated Medicaid clients, pregnant and post-partum people, children, Tribes, and Indian health care providers.


In January 2021, we requested an extension, which would create a sixth year for MTP. If Centers for Medicare & Medicaid Services (CMS) approves Washington State’s extension, MTP will continue from January 1–December 31, 2022.

If CMS approves our renewal, it will create a new MTP period for Washington State from January 1, 2023–December 31, 2027.

Next steps

We’ll be posting additional information and resources as they become available. Stay tuned for our renewal public comment webinars, which will be held in fall 2021.