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Apple Health (Medicaid) rulemaking
This page includes all of the current rule making activity for Washington Apple Health (Medicaid)
Eligible provider types
Affected WAC: 182-502-0002
Description: To fix erroneous cross-reference in subsection (1)(c) and align the titles of the applied behavior analysis (ABA) professionals in (1)(c)(i)-(iii) with those listed in WAC 182-531A-0800.
Conditions of payment and prior auth requirements - Medicare coinsurance, copayments, and deductibles
Affected WAC: 182-502-0110
Pending formal proposal
Description: The Health Care Authority (HCA) is amending WAC 182-502-0110 to add that for long-term civil commitments, if Medicare and Medicaid cover the service, HCA pays the greater of Medicare or Medicaid’s allowed amount, minus what Medicare paid.
Washington apple health - Application processing times
Affected WAC: 182-503-0060
Description: The agency is making housekeeping changes only. WAC 182-503-0060(2) contains cross-references to WAC 182-503-0005(2) which need to be changed to WAC 182-503-0005(8). The agency will also edit the rule to replace instances of “WAH” with “apple health.
Affected WAC: 182-502-0016
Description: The agency is creating a new section within this chapter to meet the Centers for Medicare and Medicaid Services (CMS) milestone requirement 3 regarding the agency’s Section 1115 Substance Use Disorder (SUD) Waiver Implementation Plan. Milestone 3 requires the adoption of rules reflecting the requirement that residential treatment facilities offer medication assisted treatment access on-site or facilitate off-site access. The agency is also initiating this rulemaking to implement provisions of RCW 71.24.585 related to behavioral health agencies and medication assisted treatment. Initially this rulemaking was proposed as a new section 182-502-0016a. The agency decided to add the proposed language into the existing WAC section, 182-502-0016, instead of creating a new section.
Emergency Adoption (CR103E) - WSR 20-10-011
Preproposal (CR101) - WSR 20-10-012
Emergency Adoption (CR103E) - WSR 20-17-137
Emergency Adoption (CR103E) - WSR 21-01-126
Emergency Adoption (CR103E) - WSR 21-09-032
Proposal (CR102) - WSR 21-07-067
Hearing date: 4/27/2021
*Comments due 4/27/2021
Permanent Adoption (CR103P) - WSR 21-10-081
Administrative hearings rules
Affected WAC: 182-526-0010, 182-526-0030, 182-526--0040, 182-526--0070, 182-526-0340
Description: The agency is considering amending procedural rules applicable to adjudicative proceedings to permit the use of electronic means to file and serve documents and conduct and attend hearings.
Affected WAC: 182-526-0195
Description: The agency is amending WAC 182-526-0195 to change subsection (4) to specify that the administrative law judge has discretion to grant or deny an agency request for a prehearing conference.
Administrative hearings and appeals
Affected WAC: 182-51-1800, 182-526-0005, 182-70-110, 182-70-655, 182-70-660, 182-526-0195, 182-526-0203, 182-526-0205, 182-526-0206
Description: Revisions to these sections are necessary due to the revisions HCA is making to WAC 182-526-0005, Purpose and scope, which HCA filed a CR-101 under WSR 20-11-072 on May 20, 2020. Consistency is needed between Chapters 182-51, 182-70, and 182-526 WAC regarding hearings and appeals.
Applied Behavior Analysis (ABA)
Affected WAC: 182-501-0060, 182-531A-0100, 182-531A-0200, 182-531A-0400, 182-531A-0500, 182-531A-0600, 182-531A-1100, 182-531A-0300, 182-531A-0700, 182-531A-0800, 182-531A-0900, 182-531A-1200
Description: In WAC 182-531A, the agency is revising these rules to remove the age limits for applied behavioral analysis (ABA) and update language to remove child or children and replace with client. In WAC 182-501-0600, the agency is updating the “N” (No) to a “Y” (Yes) in the ABA covered services table for ABP 21+, CN 21+ and MN 21+. The agency is also updating the ambulance section in the covered services table for ABP21+ to a “Y” (Yes) as it was inadvertently left blank.
Preproposal (CR101) - WSR 21-04-112
Filed date: 2/1/2021
Emergency Adoption (CR103E) - WSR 21-04-111
Effective: 02/01/2021 - 05/27/2021
Emergency Adoption (CR103E) - WSR 21-12-071
Effective date: 05/28/2021 - 09/21/2021
Emergency Adoption (CR103E) - WSR 21-19-147
Effective: 09/22/2021 - 01/18/2022
Emergency Adoption (CR103E) - WSR 22-03-096
Effective: 1/19/2022 - 5/19/2022
Proposal (CR102) - WSR 22-04-102
Hearing Date: 3/8/2022
*Comments due by: 3/8/2022
Permanent Adoption (CR103P) - WSR 22-08-035
Retroactive certification period postpartum coverage; definitions
Affected WAC: 182-504-0005, 182-500-0010, 182-500-0020, 182-500-0035
Pending formal proposal
Description: The agency is amending WAC 182-504-0005 and sections of chapter 182-500 WAC, Medical definitions, to implement requirements in RCW 74.09.830 regarding postpartum health care coverage. The amended rules will provide for retroactive postpartum coverage and define after-pregnancy coverage, continuous eligibility, and full scope coverage.
Community Behavioral Health Support Services (CBHSS)
Pending formal proposal
Description: The agency intends to establish rules regarding eligibility determinations for the CBHSS program, which helps certain people with supervision and skills restoration services.