MTP renewal

HCA is seeking approval from Centers for Medicare & Medicaid Services (CMS) to renew our existing MTP waiver, called "MTP 2.0," to:

  • Expand coverage and access to care, ensuring people can get the care they need.
  • Advance whole-person primary, preventive, and home- and community-based care.
  • Accelerate care delivery and payment innovation focused on health-related social needs.

If approved, the MTP renewal waiver will allow our state to continue to develop innovative projects, activities, and services that improve Apple Health (Washington State's Medicaid program).

Learn about MTP's short extension below. 

About the renewal

On July 15, 2022, the Health Care Authority (HCA) and Department of Social and Health Services (DSHS) submitted the MTP 2.0 waiver renewal application. We began negotiating with CMS on MTP 2.0 in October. However, CMS will not finish their negotiations by the end of this year.

Short extension

CMS approved a short extension—from January 1–June 30, 2023—to the current MTP waiver period, which was scheduled to end December 31, 2022.

This extension will allow:

  • Current MTP programs to continue, and Apple Health enrollees can continue to have access to services without disruption of care.
  • Time for CMS to continue to review Washington’s MTP 2.0 application.
  • Our state to continue to negotiate and work with CMS.

Important note: CMS’ short extension is different than the one-year extension our state received because of COVID-19.

Read our FAQ

Proposed programs under the renewal

If approved, existing MTP programs (within the current MTP waiver) will continue and/or expand under the renewal. These include:

  • Long-Term Services and Supports (LTSS)
  • Foundational Community Supports (FCS)
  • Substance use disorder (SUD) IMD*
  • Mental health IMD*

If approved, we will launch several new programs under the renewal:

  • Taking Action for Healthier Communities (TAHC)
  • Continuous Apple Health enrollment for children
  • Reentry coverage for continuity of care
  • Apple Health postpartum coverage expansion
  • Washington Integrated Care Assessment (WA-ICA)

Learn more.

About MTP

MTP allows our state to improve Washington’s health care system using federal Medicaid funding. Washington State is currently in the last year of the current MTP waiver, which ends December 31, 2022.

All work under MTP benefits people enrolled in Apple Health. Learn more about MTP.


Short extension (to the current MTP waiver period)


Public hearings

Learn more

*IMD stands for institution for mental diseases. IMDs are defined as hospitals, nursing facilities, or other institutions with more than 16 beds that primarily provide diagnosis, treatment, or care of persons with mental illnesses. This includes medical attention, nursing care, and related services.

We acknowledge the term “mental disease” may be harmful or stigmatizing. We use it in this context only to reflect the legal terminology used in statute.