Description
The agency is revising these sections to add behavioral support specialists as an eligible provider type and add behavioral health support specialist definition to align with the state plan definition.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Nominating Committee

The Nominating Committee recruits and selects members for the Cost Board’s advisory committees. Their job is to ensure an effective and appropriate mix of representation and diversity (including gender, geography, expertise, background, and qualifications) when selecting advisory committee members who adhere to the strategic vision of the board.

Meetings

Nominating Committee meetings are held on in-person at HCA and on Zoom. Find information on Nominating Committee meetings on the Cost Board’s Meetings and materials page.

Public comment

All Nominating Committee meetings are public meetings, and members of the public are welcome and encouraged to share their input. All feedback is shared with board members.

Share your input

There are two ways to share input:

  • During a committee meeting, there is a designated time for public comment. To provide public comment during the designated public comment period, please use the raise hand function in Zoom or raise your hand if you are attending in person.
  • By contacting us at any time. If you want your written comments to be included in an upcoming meeting, email your comments to us 10 days before that meeting occurs.

Committee members

The Nominating Committee is made up of three members of the Cost Board.

Ingrid Ulrey

Chief executive officer, Washington Health Benefit Exchange

Ingrid Ulrey is the chief executive officer for Washington Health Benefit Exchange (Exchange). She is a health care executive with an extensive history and passion for expanding access to care, driving health system transformation, and advancing equity. In her role as Exchange CEO, she oversees the entirety of the Exchange’s activities and works closely with the Governor-appointed Exchange Board, leadership, and staff to define and execute their mission.

Prior to her appointment as Exchange CEO, Ulrey served in the Biden Administration as regional director for the U.S. Department of Health and Human Services (HHS) — serving Alaska, Idaho, Oregon, Washington, and the 272 federally recognized tribes. Before HHS, Ulrey was policy director for public health — Seattle & King County, where she was a lead strategist of the region’s COVID-19 response.

Ulrey’s leadership in the health sector is informed by work at the national level, including five years with the Service Employees International Union based in Washington, DC; at the state level, including eight years state legislative sessions in Olympia as advocacy director for AARP; and with a global perspective on health from more than five years in the Middle East and Southeast Asia, most recently with PATH, based in Yangon, Myanmar. She has a master’s in public policy, public policy analysis from Georgetown University and a bachelor’s in cultural anthropology from University of California, Santa Cruz.

Kim Wallace

Medical administrator, Office of the Medical Director, Washington State Department of Labor & Industries

Over the past 25 years, Kim has held numerous public and private sector leadership positions in health care policy and finance, health IT, health benefits management, and public health. She has an MBA from Wharton and a B.S. in Clinical Dietetics from the University of Washington.

Carol Wilmes

Director, Member Pooling Programs, Association of Washington Cities (AWC)

Carol Wilmes oversees AWC's Employee Benefit Trust, Risk Management Service Agency, Workers' Comp Retrospective Rating Program, and Drug & Alcohol Consortium. For most of her 38 years with the AWC, Carol administered the Employee Benefit Trust, insuring 36,000 members from over 280 municipalities and special purpose districts. She serves as a resource for labor-management task forces addressing the complexities of health care coverage, and frequently speaks at the state and national level on governmental entity health pools and public sector risk management trends.

She was appointed to the Washington State Health Benefit Exchange Advisory Committee in 2015; serves as chair to the Board of Directors to the National League of Cities Risk Insurance Sharing Consortium; and serves on the Washington Health Alliance Board of Directors and Executive Committee.

00426: The ProviderOne system will be unavailable from 5 a.m. Saturday, September 21 until 9 a.m. Sunday, September 22 (28 hours) due to scheduled maintenance
Discovery log number
00426
Discovery description

The ProviderOne system will be unavailable from 5 a.m. Saturday, September 21 until 9 a.m. Sunday, September 22 (28 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.

Date reported
ETA
Provider impact
All Providers
Workaround
Please report any issues to: mmishelp@hca.wa.gov.
00425: To all ProviderOne users ProviderOne Maintenance planned for Sunday, September 15, 2024
Discovery log number
00425
Discovery description

The ProviderOne system will be undergoing maintenance from 6 a.m. to 10 a.m. Sunday, September 15, 2024 (4 hours).  Although we do not expect the maintenance activity to result in a full outage, there is the potential for intermittent outages or degraded performance during the maintenance period.

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.

Date reported
ETA
Provider impact
All Providers
Workaround
Please report any issues to: mmishelp@hca.wa.gov.

Tribal affairs

The Office of Tribal Affairs provides support and communication with tribes and tribal-related organizations for American Indian/Alaska Native (AI/AN) health care.

Goals

  • Offer information to American Indians and Alaska Natives regarding health care coverage options, crisis services and transitional care planning, and mental health and substance use disorder prevention, treatment, and recovery support.
  • Manage Indian Nation Agreements (INA) and other agreements with tribes, tribal related organizations, and Indian health care providers for their delivery of  health related programs. 
  • Develop policies and programs in partnership with tribes and Indian health care providers. 
  • Provide technical assistance and training to HCA staff on government-to-government relations and cultural humility.
  • Meet and communicate regularly with tribes, tribal-related organizations and Indian health care providers.
  • Collaborate with tribes and Indian health care providers to develop and maintain government-to-government plans for crisis, care coordination and transition planning, and mutual program goals.  
    • Work with Administrative Service Organizations (ASO), Managed Care Organizations, and service providers to implement the government-to-government plans. 
  • Facilitate meetings between HCA and tribes, including Tribal Consultations.
  • Respond to tribal-related questions and issues.
  • Provide technical assistance to tribes, Indian health care providers, and Managed Care Organizations (MCOs) on HCA policies for Apple Health (Medicaid) claims submission and adjudication.  
  • Assist tribes and Indian health care providers with issues and concerns.

How do I?

American Society of Addiction Medicine (ASAM)

The ASAM Criteria defines the treatment criteria and levels of care for the treatment of substance-related and co-occurring conditions. The ASAM Criteria structure is the underlying framework for our service codes (billing guides), fiscal assumptions (rates), etc.

Under state law, licensed behavioral health agencies (BHA) providers are required to use The ASAM Criteria. Managed care organizations (MCOs), behavioral health administrative services organizations (BH-ASOs) contracted by the Health Care Authority (HCA), and private insurance plans use The ASAM Criteria as a utilization management tool.

The ASAM Criteria, 4th Edition, Volume 1, Adults is now available.

Want to stay up to date on the ASAM?

4th edition timeline

SB 5361 passed in the 2025 legislative session, delaying the adoption date until January of 2028.

Read the ASAM adoption readiness FAQ

While the adoption date is delayed, clinicians are encouraged to continue to work on quality improvement and attend trainings through June of 2025. 

Training courses will:

  • Be held virtually.
  • Start in July 2024 and run through June 2025.
  • Be offered by the Train for Change Company and free of charge (funded by the Washington State Legislature and State Opioid Response Grant).

The Adolescent and Transition Age Youth version is anticipated to be released in 2026.

4th edition trainings

Tier 1: The Evolution of The ASAM Criteria: What’s New in the 4th Edition.

This is a great training for a broad audience who works in the field and wants a consolidated overview of the ASAM updates. Tier 1 training is for anyone and everyone in the behavioral health field.

Tier 2: Two-day ASAM Criteria 4th Edition Skill-building Training

This is a prerequisite for Tier 3 training. Tier 2 training will benefit clinicians who are newer to the field or are substance use disorder professionals who would benefit from an in-depth course.

Tier 3: Implementation, Improvement, Sustainability, and Coaching of The ASAM Criteria. A “How to,” Science-based Approach.

This training is designed for clinical supervisors, directors, administrators, and decision makers who play a key role in implementation and ongoing support of adopting the changes within their organization.

How do I participate in trainings?

  • Read the 4th edition ASAM FAQ.
  • Select the training that you want to attend.
  • Sign up using the email address for the location where you will attend the virtual training.
  • Once registered, you will receive an email confirmation.
    • Spots are limited. Please reach out to the contact person on the confirmation email to cancel the training if you cannot attend.

All trainings are offered by the Train for Change company. Although the trainings are free of charge, you will need to purchase The ASAM Criteria, 4th Edition.