Washington state gets green light for Medicaid, LTSS overhaul

The Centers for Medicare & Medicaid Services has given preliminary approval to a waiver that will allow Washington health officials to revamp the state's Medicaid program.

The five-year CMS waiver would give the state $1.5 billion to overhaul Medicaid, including new options for beneficiaries requiring long-term services and supports. It could set the stage for other states to follow suit with revamping their long-term care options for Medicaid beneficiaries.

State officials proposed the waiver as a way to handle Washington's growing Medicaid population, which has increased 60% since 2013, according to Modern Healthcare.

Among the proposals to be implemented under the waiver is a new Medicaid Alternative Care package for beneficiaries who are eligible for Medicaid but not currently receiving long-term services and supports. The package would allow beneficiaries to choose from a community-based option that supports unpaid family caregivers to help avoid or delay the need for “more intensive Medicaid-funded services.”

Washington also would use the waiver to create a new Medicaid eligibility category and benefits package, “Tailored Supports for Older Adults,” that caters to beneficiaries who are “at risk” for future Medicaid use for long-term services and supports.

The waiver is expected to be finalized in the coming weeks once specific conditions are agreed upon by state and federal officials.