Apple Health (Medicaid) rulemaking
This page includes all of the current rule making activity for Washington Apple Health (Medicaid)
Tailored supports for older adults (TSOA) - Presumptive eligibility (PE)
Affected WAC: 182-513-1620
Description: The agency is amending the presumptive eligibility period from twelve to twenty-four months to align with Title 388 WAC.
Determining excluded income for LTC services
Affected WAC: 182-513-1340
Description: The agency is revising this rule to clarify excluded income requirements by removing the reference in subsection (1)(j) to child support received from a noncustodial parent.
Fully integrated managed care and choice
Affected WAC: 182-538A-060
Description: The agency is revising WAC 182-538A-060, Fully integrated managed care and choice, to remove language indicating that enrollment in a behavioral health services only (BHSO) managed care organization (MCO) is mandatory for American Indian and Alaska native (AI/AN) clients and their descendants.
Affected WAC: 182-531-1730
Description: The agency is revising WAC 182-531-1730, Telemedicine, to include renal dialysis centers to the list of originating sites for telemedicine, as allowed in SSB 5157.
Affected WAC: 182-531-1600
Description: The agency is revising WAC 182-531-1600, Bariatric surgery, to reflect coverage changes made by the Health Technology Clinical Committee.
Provider Preventable conditions (PPC) - Payment policy
Affected WAC: 182-502-0022
Description: Correcting where hospitals must report other provider preventable condition (OPPC) associated with an established Medicaid client in subsection (6)(d)(i), and correcting a web address in . Also correcting a bad web address in subsection (6)(d)(ii).
Health care for workers with disabilities (HWD) - Disability requirements
Affected WAC: 182-511-1150
Description: The agency is amending this rule to replace incorrect references to the developmental disabilities administration (DDA) with the correct program name of division of disability determination services (DDDS).
Scope of Services
Affected WAC: 182-501-0060
Description: The agency is amending WAC 182-501-0060, Health care coverage—Program benefit packages—Scope of service categories to implement E2SSB 5179, which restores coverage of hearing instruments for adults.
Affected WAC: 182-502-0016
Description: The agency is updating this section to provide notice to providers and support enforcement of compliance with state and federal requirements related to the operations of entities receiving more than $5 million in Medicaid payments annually, including but not limited to such entities providing information about the False Claims Act and establishing written policies for employees.
Provider enroll, termination
Affected WAC: 182-502-0012, 182-502-0040, 182-502-0060
Description: The agency is WAC 182-502- 0012(5) and WAC 182-502-0040(2) to allow the dispute resolution process under WAC 182-502-0050, with the exception of WAC 182-502-0050(6), for providers who are denied enrollment, and for terminations of a provider agreement for convenience. The agency is amending WAC 182-502-0060 to remove subsections (1) and (2) that prohibit providers from reapplying for participation after the agency denies enrollment or removes a provider from participation. The agency has determined that the rules need to be amended to allow for due process and for reporting purposes.