Apple Health (Medicaid) rulemaking
This page includes all of the current rule making activity for Washington Apple Health (Medicaid)
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.
Premium payment program
Affected WAC: Chapter 182-558
Description: The agency is amending Chapter 182-558 WAC to clarify and update eligibility criteria for clients receiving premium assistance subsidies for comprehensive health insurance.
Medical Assistance definitions - N
Affected WAC: 182-500-0075
Description: The agency is amending this rule as a result of federal regulations published February 2016 under 42 C.F.R. Part 440. The agency is adding a definition for “nonphysician practitioners,” a term which will be used in two WAC chapters to be amended in separate rulemaking actions as a result of the February 2016 federal regulations. The agency previously filed a Preproposal Statement of Inquiry in 2016 to begin rulemaking on this and other sections under WSR 16-11-094. The agency subsequently withdrew the previously filed Preproposal Statement of Inquiry under WSR 18-05-031 and is rewriting the proposed rule.
Definitions - C
Affected WAC: 182-500-0020
Description: The agency is revising this rule to correct a typo in the definition of “Community spouse.” The WAC citation referenced in the definition should read WAC 182-500-0100.
Affected WAC: 182-502A-0201, 182-502A-0301, 182-502A-0401, 182-502A-0601, 182-502A-0701, 182-502A-0801, 182-502A-0901, 182-502A-1001
Description: The agency is amending Chapter 182-502A, Program integrity, to update definitions and clarify processes.
Nonbilling Individual Providers
Affected WAC: 182-502-0006
Description: The agency is amending rules to provide additional options for the provider networks of managed care organizations to enroll with the Health Care Authority in order to comply with 42 C.F.R. 438.602(b).
Administrative Hearings - ICF/IID
Affected WAC: 182-526-0005
Description: The agency is amending this chapter to add administrative hearing rules for actions related to intermediate care facilities for individuals with intellectual disabilities (ICF/ID), in alignment with federal regulations.
Orders of default; Orders of dismissal
Affected WAC: 182-526-0284, 182-526-0285
Description: The agency is revising WACs 182-526-0284 and -0285 to align with the changes proposed in WAC 182-526-0290 which were made to be consistent with the Administrative Procedures Act.
Affected WAC: 182-526-0070, 182-526-0155, 182-526-0200
Description: The agency is revising these rules to: (1) to allow for support staff to confirm receipt of filed documents, rather than a judge in WAC 182-526-0070; (2) add language to WAC 182-526-0155 that was inadvertently omitted in a previous version; and (3) clarify where the hearing may take place in WAC 182-526-0200(3).
Expedited hearings, continuing and reinstating a hearing
Affected WAC: 182-526-0100, 182-526-0280, 182-526-0290
Description: To comply with new federal rules in 42 CFR Part 431, the agency is creating a new section WAC 182-526-0100 to allow for expedited administrative hearings for urgent health care needs. The agency is revising WAC 182-526-0290(4) and (6) to correct an error in the recently filed permanent rules for Chapter 182-526 WAC. In subsection (4), if an appellant fails to appear at the scheduled prehearing conference to address the petition to vacate, the order becomes a final order. The ALJ or review judge does not dismiss the matter with prejudice. In subsection (6), if the petition to vacate is not filed timely or the appellant fails to establish good cause to excuse any default or to reinstate the matter for hearing, the ALJ must issue an initial order, not a final order, dismissing the appeal. In WAC 182-526-0280, the agency is proposing to strike the introductory statement “This section applies to continuance requests made by applicants or recipients.” During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy.
Emergency Adoption (CR103E) - WSR 17-08-087
Emergency Adoption (CR103E) - WSR 17-08-088
Effective: 4/4/17 - 7/31/17
Preproposal (CR101) - WSR 17-08-089
Proposal (CR102) - WSR 17-15-044
Hearing date: 8/22/17
*Comments due by COB
Emergency Adoption (CR103E) - WSR 17-16-153
Effective: 8/1/17 - 11/28/17
Emergency Adoption (CR103E) - WSR 17-16-141
Effective: 8/1/17 - 11/28/17
Emergency Adoption (CR103E) - WSR 17-24-033
Emergency Adoption (CR103E) - WSR 17-24-034
Permanent Adoption (CR103P) - WSR 17-24-103