CMS approves amendment to Washington's Medicaid Transformation Project

Wed, 11/18/2020

The Health Care Authority (HCA) is pleased to announce the Centers for Medicare & Medicaid Services (CMS) approved an amendment to our state's Section 1115 Medicaid demonstration waiver. The waiver is called the Medicaid Transformation Project (MTP).

What is this amendment about?

The amendment creates a fifth initiative under MTP, called mental health IMD. IMD stands for institutions for mental diseases. They are large facilities dedicated to psychiatric care (more than 16 beds where more than 50 percent of the residents are admitted for psychiatric care).

Under the amendment, the state can purchase acute inpatient services for Medicaid clients between the ages of 21 and 65 who reside in a dedicated large psychiatric facility that qualifies as an IMD. Under the current rule, there is a 15-day limit for IMD stays. In addition, Medicaid historically excludes large psychiatric facilities from participating in Medicaid if their patients are between 21 and 65 years old.

What does this amendment mean for Washington State?

Federal funds will be used to treat Medicaid clients receiving psychiatric care while residing in an IMD facility. The initiative will increase access to care and provide more coordinated and comprehensive treatment for people who receive psychiatric care. The initiative will go through December 2021. Read the mental health FAQ.

What is MTP?

MTP is a five-year agreement with CMS that allows our state to create and continue to develop projects, activities, and services that improve Washington’s health care system. Under this waiver, Washington State will receive up to $1.5 billion through December 2021. All work under MTP benefits those enrolled in Apple Health (Medicaid).

Learn more about MTP.