Los Angeles County launched its Medicaid Coverage Expansion (MCE) under the 1115 Waiver on July 1. Healthy Way LA (HWLA) is the local initiative that will provide coverage to adults between the ages of 19 and 64 with an income up to 133 percent of the FPL, among other qualifying requirements. Enrollment in the program is being administered by the Los Angeles County Department of Health Services (DHS).

Non-contract hospitals will be reimbursed at 30 percent of the Rogers rate for ER and post-stabilization care provided to HWLA members. To verify patient eligibility and obtain authorization, hospitals need to call (877) 333-4952.

DHS has provided the following mailing address for claims submittal: Office of Managed Care-HWLA, 1000 South Fremont Avenue, Bldg A-9 East, 2nd Floor Unit 4, Alhambra, CA 91803-8859.

The following documents are available upon request from the HASC Los Angeles for hospitals that may need them:
• HWLA enrollment sites
• HWLA-MCE Implementation (PowerPoint)
• ID – HWLA sample member card
• CMS-1500/HCFA-1500 Form: Professional Claims
• CMS-1450/UB-04 Form: Hospital/Institutional Claims