How does a provider “opt out” of Medical Assistance?
Medical Assistance, unlike Medicare, does not have an “opt out” provision. However, the provider may terminate their Core Provider Agreement. The Core Provider Agreement includes provisions related to termination. In general, providers may terminate their Core Provider Agreements at any time by providing written notice to the department. See Core Provider Agreement; WAC 388-502-0030(5)(e).The provider is considered “inactive” if there has been no billing activity in a 24 month period. In these cases MAA notifies the provider his/her CPA will be terminated, unless we are notified that the provider wants to remain active. See WAC 388-502-0030(5)(b).Termination of the CPA does not assume termination of HO provider participation. If a provider chooses to terminate their contract with a HO plan, they must abide by the procedures in their contract with the plan.
