STATE OF HAWAII
DEPARTMENT OF HUMAN SERVICES
Pursuant to 42 C.F.R. §447.205, the Department of Human Services (DHS) hereby notifies the public that it intends to increase Medicaid reimbursement to certain eligible Medicaid physicians for certain primary care services. The proposed change will be submitted for review to the federal government as a Medicaid State Plan Amendment (SPA) to be effective January 1, 2017.
For the purposes of this SPA, eligible physicians are considered those who:
1. Have a specialty designation of family medicine, general internal medicine, or pediatric medicine and to subspecialists of those specialties as recognized by the American Board of Medical Specialties (ABMS), American Osteopathic Association (AOA), or American Board of Physician Specialties (ABPS); and
2. Are either board certified in that specialty or had 60 percent of their last calendar year’s Medicaid claims for Evaluation and Management and vaccine administration codes specified below.
The primary care services covered under this SPA are Evaluation and Management codes 99201 through 99239; 99291 through 99499 and vaccine administration codes 90460, 90471 through 90474, or their successor codes.
A copy of the proposed changes are available for public viewing from the first working day the public notice appears in the Honolulu Star-Advertiser, Hawaii Tribune Herald, West Hawaii Today, The Maui News, and The Garden Island, from Monday Friday, exclusive of State holidays, between the hours of 9:00 a.m. to 2:00 p.m. at the appropriate Med-QUEST Division offices on the respective islands listed below.
Department of Human Services Eligibility Office – Oahu Section
Med-QUEST Division 801 Dillingham Boulevard, 3rd Floor
Policy & Program Development Office Honolulu, Hawaii 96817
601 Kamokila Blvd., Room 518
Kapolei, Hawaii 96707-2021
Eligibility Office East Hawaii Section Eligibility Office West Hawaii Section
1404 Kilauea Avenue 75-5591 Palani Road, Suite 3004
Hilo, Hawaii 96720 (933-0339) Kailua-Kona, Hawaii 96740 (327-4970)
Eligibility Office Maui Section Eligibility Office Kauai Section
Millyard Plaza Dynasty Court
210 Imi Kala Street, Suite 101 4473 Pahee Street, Suite A
Wailuku, Hawaii 96739 (243-5780) Lihue, Hawaii 96766 (241-3575)
Eligibility Office Lanai Unit Eligibility Office Molokai Unit
730 Lanai Avenue State Civic Center
Lanai City, Hawaii 96763 (565-7102) 65 Makaena Place, Room 110
Kaunakakai, Hawaii 96748 (553-1758)
Special accommodations (i.e., interpreter, large print or taped materials) will be arranged if requested no later than seven (7) working days before the comment period ends. Neighbor island residents requesting special accommodations should contact the appropriate Med-QUEST Division offices on the respective neighbor islands listed above.
DEPARTMENT OF HUMAN SERVICES, MED-QUEST DIVISION
JUDY MOHR PETERSON, PhD
MED-QUEST DIVISION ADMINISTRATOR