Apple Health (Medicaid) rulemaking
This page includes all of the current rule making activity for Washington Apple Health (Medicaid)
Conditions of Payment
Affected WAC: 182-502-0110
Description: The agency is amending WAC 182-502-0110 to clarify prior authorization requirements for dual-eligible clients when their Medicare benefits are exhausted.
Medical Assistance Definitions - M
Affected WAC: 182-500-0070
Description: The agency is striking the definition for "Medical assistance administration," adding definitions for "Medicaid agency" and Medically needy income level, and making other changes to improve clarity.
Definitions - C
Affected WAC: 182-500-0020
Description: The agency is adding a definition for client in this section.
Affected WAC: 182-501-0070
Description: The agency is revising this rule to reference hair removal and electrolysis allowed under WAC 182-531-1675.
Experimental and Investigational Services
Affected WAC: 182-531-0050, 182-531-0550
Description: The agency is revising WAC 182-531-0050 to remove the definition of “ADSA,” clarify the definitions of “experimental” and “investigational,” and align the definition of “peer-reviewed medical literature” with other agency rules. WAC 182-531-0550 is being updated to strike redundant subsections and clarify information regarding experimental and investigational services. These revisions do not change current policy. Housekeeping changes were also made in these WACs.
Preproposal (CR101) - WSR 16-07-137
Withdrawal (CR101) - WSR 16-17-004
Preproposal (CR101) - WSR 16-17-094
Proposal (CR102) - WSR 16-24-055
Hearing date: 1/10/17
*Comments due by COB
Supplemental (CR102) - WSR 17-05-092
Hearing date: 3/21/17
*Comments due by COB
Affected WAC: 182-526-0005, 182-526-0010, 182-526-0020, 182-526-0025, 182-526-0035, 182-526-0040, 182-526-0070, 182-526-0080, 182-526-0085, 182-526-0095, 182-526-0102, 182-526-0115, 182-526-0135, 182-526-0150, 182-526-0155, 182-526-0175, 182-526-0185, 182-526-0195, 182-526-0200, 182-526-0215, 182-526-0221, 182-526-0230, 182-526-0240, 182-526-0245, 182-526-0250, 182-526-0255, 182-526-0270, 182-526-0280, 182-526-0282, 182-526-0284, 182-526-0285, 182-526-0290, 182-526-0300, 182-526-0340, 182-526-0350, 182-526-0360, 182-526-0370, 182-526-0375, 182-526-0380, 182-526-0387, 182-526-0390, 182-526-0415, 182-526-0450, 182-526-0495, 182-526-0500, 182-526-0520, 182-526-0525, 182-526-0540, 182-526-0550, 182-526-0555, 182-526-0560, 182-526-0575, 182-526-0580, 182-526-0595, 182-526-0600, 182-526-0605, 182-526-0640, 182-526-0650
Description: The agency amended these rules to make the hearing process more efficient and streamlined.
Affected WAC: 182-530-7700, 182-531-0250, 182-502-0006
Description: The agency is amending rules to comply with Section 1902(a)(10)(E) of the Social Security Act that requires changes to payment of Medicare cost sharing for qualified Medicare beneficiaries.
21st Century Cures Act
Description: The WAC needs to be amended to implement Title V, Sec. 5007 the 21st Century Cures Act to allow for a person to create his or her own D4A special needs trust. The agency also needs to revise references to incorrect WAC citations in WAC 182-516-0100.
Suspending medication during incarceration
Affected WAC: 182-500-0070, 182-502-0100, 182-503-0070, 182-503-0505, 182-503-0525, 182-504-0015, 182-504-0120, 182-505-0210, 182-505-0211, 182-506-0015, 182-523-0100
Description: The agency is amending these rules to comply with SSB 6430, which requires the agency to suspend, rather than terminate, medical assistance benefits for people who are incarcerated or committed to a state hospital.
Affected WAC: 182-509-0320, 182-512-0050, 182-512-0550, 182-512-0860, 182-527
Description: These rules are necessary to implement ESHB 2323 Individuals with disabilities – Savings and investments – Achieving a Better Life Experience (ABLE) Act. An ABLE account allows blind or disabled clients to save funds in tax-advantaged accounts for their disability-related expenses. The agency is amending additional WAC sections to support the implementation of this program. These changes include adding assets held in an ABLE account to the list of resource exclusions when determining eligibility, adding the distributions from an ABLE account for qualifying expenses to the list of income exclusions for identifying countable income when determining eligibility, and adding that contributions up to the specified annual amount and earnings on an ABLE account are not counted when determining eligibility.