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One year extension and amendment

The Medicaid Transformation Project (MTP) is Washington’s Section 1115 Medicaid demonstration waiver between the Health Care Authority (HCA) and Centers for Medicare & Medicaid Services (CMS).

In early 2021, our state requested an MTP one-year extension because of disruptions from the COVID-19 pandemic. CMS approved our request, and MTP will continue for a sixth year. MTP will now end December 31, 2022, unless CMS authorizes additional renewal/extensions.

In addition, HCA is seeking CMS approval to amend our existing MTP waiver to:

  • Provide flexibility related to long-term services and supports (LTSS).
  • Align the value-based payment (VBP) target for year 5 of MTP because of state adjustments due to COVID-19.

About the extension

The COVID-19 pandemic has strained our health care system, essential workers, families, and communities. It has uncovered structural inequities in the health care system, and dramatically affected vulnerable populations and the providers who serve them. MTP continues to be well-positioned to address COVID-19 challenges.

Our now-approved extension will allow Washington State to continue its COVID-19 relief efforts through each of the MTP initiatives. 

About the amendment

We are requesting an amendment to:

  • Extend the LTSS presumptive eligibility process so patients can access essential services immediately, rather than having to undergo a financial eligibility determination and a full functional eligibility assessment first. This change would also include access to appropriate LTSS programs through Community First Choice and 1915(c) waivers.
  • Change the definition to allow transportation to community supports and services. Through this amendment, Washington State will offer transportation—according to a participant’s service plan—to MTP-based services, community supports, and other activities specified in the service plan.
  • Adjust the 2021 managed care organization VBP adoption target from 90 percent to 85 percent. This adjustment has already been made within Apple Health contracts. This change will ensure the MTP target aligns with the Apple Health Appendix and state VBP target because of COVID-19.  In addition, the state is seeking an adjustment to the way improvement is calculated for VBP-related incentives under MTP.