Apple Health (Medicaid) rulemaking

This page includes all of the current rule making activity for Washington Apple Health (Medicaid)

Rule making activities

Description
The agency is updating the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) chapter to align with guidance from the Centers for Medicare & Medicaid Services.

Agency contacts

Rulemaking contact

Melinda Froud

Program contact

Christine Cole

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending its rules to increase the income standards for pregnancy and postpartum groups from 193% to 210% of the federal poverty level. This
increase is consistent with legislative directives in chapter 213, Laws of 2024 (2E2SSB 5580).

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Kristina Bair

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The State Supplemental Operating budget (section 211 (34), Chapter 376, Laws of 2024, (ESSB 5950)), included funding for the Health Care Authority (HCA) to implement a birth doula benefit for Apple Health (Medicaid) clients. HCA is developing rules in Chapter 182-533 WAC and amending WAC 182-502-0002 to accomplish this.

Agency contacts

Rulemaking contact

Jason Crabbe

Program contact

Michelle Madrigal

Rulemaking status history

Preproposal (CR101)

Emergency Adoption (CR103E)

Emergency Adoption (CR103E)

Proposal (CR102)

Description
The agency is amending this rule to expand screening and preventative services for certain sexually transmitted infections during a client visit focused on family planning.

Agency contacts

Rulemaking contact

Melinda Froud

Program contact

Andrea Estes

Rulemaking status history

Preproposal (CR101)

Withdrawal (CR101)

Emergency Adoption (CR103E)

Emergency Adoption (CR103E)

Emergency Adoption (CR103E)

Emergency Adoption (CR103E)

Emergency Adoption (CR103E)

Preproposal (CR101)

Description
RCW 74.09.830 provides full-scope coverage for 12 months postpartum for pregnant or postpartum persons. This coverage is more generous than and thus replaces the limited scope “Family planning only – Pregnancy related program.” The agency intends to remove language related to this superseded program from chapter 182-532 WAC.

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Melissa Rivera

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending this chapter to clarify rules for RHCs applying for a change in scope rate adjustment and an interim-rate to final-rate adjustment. Additionally, the agency plans to add detailed clarification to the rules regarding adding dental services to an RHC through a change in scope application.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Patrick Miles

Rulemaking status history

Preproposal (CR101)

Description
The agency is adding a new section describing system requirements for electronic visit verification (EVV) for home health care services.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Greg Sandoz

Rulemaking status history

Preproposal (CR101)

Agency contacts

Rulemaking contact

Melinda Froud

Program contact

Lisa Little

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Description
The agency is revising these rules to allow for reimbursements of professional services for home infusions.

Agency contacts

Rulemaking contact

Melinda Froud

Program contact

Fawn Ross

Rulemaking status history

Preproposal (CR101)

Description
Updating chemical-using pregnant (CUP) women to substance-using pregnant people (SUPP). The revision allows for alignment with agency standard language.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Melissa Craig

Rulemaking status history

Expedited Adoption (CR105)