00454: Thanksgiving Holiday will impact ProviderOne claims submission deadline and payment date
Discovery log number
00454
Discovery description

In observance of Thanksgiving, state offices will be closed Thursday, November 27, 2025 and Friday, November 28, 2025. As a result, provider payments for the week of November 24, 2025 will be made on Wednesday, November 26, 2025, including the delivery of Remittance Advices (RAs) and HIPAA 835 remittance files.

Claim submission deadlines have been moved up to ensure that providers are able to receive payment and RA documents on November 26, 2025.

The deadline for submission of claims to ProviderOne for payment during the week of Thanksgiving will be Sunday, November 23, 2025, by 5 p.m.

The deadline for submission of pharmacy claims to the Point of Sale (POS) during the week of Thanksgiving will be Saturday, November 22, 2025, by 5 p.m.

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

Thank you.

Date reported
ETA
Workaround
Please report any issues to: mmishelp@hca.wa.gov.
Description
The agency is removing CDT® code D9630 from coverage under the dental benefit as these drugs and medicaments are available under the client’s pharmacy benefit when prescribed and the prescription is filled at a pharmacy. As a result, the agency is revising WAC 182-535-1098 to reflect this change and to also clarify that these services are still available under the client’s pharmacy benefit. Additionally, the agency is updating the term conscious sedation to moderate sedation to align with industry standard language.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Jayson Diaz

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

  • WSR 26-02-059
  • Hearing Date: 02/10/26
  • Registration is required to attend the public hearing.
    View the rulemaking's CR102 for the registration link.
  • Comments Due: 02/10/26

Permanent Adoption (CR103P)

00453: ProviderOne outage planned for Saturday, November 8, 2025
Discovery log number
00453
Discovery description

The ProviderOne system will be unavailable from 11 a.m. until 8 p.m. on Saturday, November 8, 2025 (9 hours) due to scheduled maintenance.

This outage does not affect the Pharmacy POS

Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

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

Thank you.

Date reported
ETA
Provider impact
All Providers
Workaround
N/A
Description
The agency is amending its rules so that home equity limits do not apply to applicants receiving services through a nursing facility level of care determination unless the client is applying for institutional or home and community based waiver programs. The agency is also amending WAC 182-513-1250 to update the circumstances under which a client is not eligible for community first choice services.

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Paige Lewis

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

  • WSR 26-03-061
  • Hearing Date: 2/24/2026
  • Registration is required to attend the public hearing.
    View the rulemaking's CR102 for the registration link.
  • Comments Due: 2/24/2026

Permanent Adoption (CR103P)

Description
The agency is amending the spousal impoverishment rule (WAC 182-513-1660) to update the tailored supports for older adults (TSOA) resource standard. The agency changed the TSOA resource standard effective October 9, 2023, by amending WAC 182-513-1640 under WSR 23-19-014, but neglected to update WAC 182-513-1660 at that time.

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Paige Lewis

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

  • WSR 26-03-060
  • Hearing Date: 2/24/2026
  • Registration is required to attend the public hearing.
    View the rulemaking's CR102 for the registration link.
  • Comments Due: 2/24/2026

Permanent Adoption (CR103P)

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