Description
The agency is amending these rules to align with ESSB 6194 stating that any rural hospital that is located on a federally recognized Indian reservation will be eligible for payments for clients eligible for medical assistance programs for services provided by the rural hospital, regardless of the managed care enrollment status of the client. Payments are made at 150 percent of the fee-for-service rate for inpatient and outpatient hospital services when the services are provided by the rural hospital, not including any beds in the psychiatric until.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Insurance ID cards

Whether you call it an insurance card, an ID card, or a health insurance ID card, these cards are proof of enrollment in your PEBB or SEBB medical and pharmacy plans. You need this card when you visit doctors, fill prescriptions, or get care. Contact your plan (PEBB, SEBB) with questions.

When to expect your insurance ID cards

You will usually receive your insurance ID cards after your coverage becomes active.

  • New employees: Your ID cards are typically mailed within 7 to 10 business days after your coverage start date.
  • New retirees: Your ID cards are typically mailed withing 7 to 10 business days after your retiree coverage effective date.
    (UMP Classic Medicare with Part D members will receive a separate ID card for pharmacy benefits. These are typically mailed 2 to 3 weeks after your effective date.)
  • Open enrollment: If you made changes to your health plans during open enrollment, you will receive new ID cards by January of the new year. In some cases, you may receive new cards even if you didn't change plans.

Dental and vision insurance ID cards

You do not need an insurance ID card to receive dental or routine vision services.

I need an insurance ID card

If you need an insurance card because you didn't receive one or it was lost or damaged, contact your plan (PEBB, SEBB). You may also visit your plan's website, sign in to their member portal, or use their mobile app (if available).

Keep your address up to date

Make sure we have your current mailing address.

Your health plans are unable to update your address. You must update it with:

Keeping your information up to date helps ensure you receive your insurance cards without delays.

0469: Social Service RA Denials with RA Remark Code N54 and Adjustment Reason Codes / NCPDP Rejection Codes 16
Discovery log number
00469
Discovery description

Some social service claims were denied due to an authorization error posted to the auth line due to a system issue. The Health Care Authority (HCA) is working with the ProviderOne system vendor to identify these authorizations and claim lines to resolve the errors as quickly as possible.

The Remittance advice will show the TCN in the Denied section with Remark Code N54, and Adjustment Reason Codes / NCPDP Rejection Codes 16.

Provider claims may be denied if the authorization line was in error due to a system issue when the claim was submitted to the system.

Date reported
ETA
Provider impact
Phase 2
Workaround
The Health Care Authority will identify these denied claims and resurrect the claims to generate payment to impacted providers once a week until this issue is resolved.
If the provider prefers, they can attempt to resubmit the claim rather than waiting for the HCA to reprocess the claim.
00468: ProviderOne maintenance planned for Friday, May 1, 2026
Discovery log number
00468
Discovery description

To all ProviderOne users

ProviderOne maintenance planned for Friday, May 1, 2026

A zero-downtime maintenance activity will be conducted on the ProviderOne system from 6 p.m. until 9 p.m. on Friday, May 1, 2026 (3 hours).  This activity will not require an outage, however there may be intermittent connectivity degradation during the maintenance window.  Although there is no impact expected, we wanted you to be aware of this maintenance activity.

This maintenance activity does not affect the Pharmacy POS

Please report any issues to: mmishelp@hca.wa.gov.

Thank you.

Date reported
ETA
Provider impact
All Providers
Workaround
N/A