Apple Health (Medicaid) rulemaking

The agency is amending WAC 182-526-0030 to update the Board of Appeals’ website address. The agency is amending WAC 182-526-0580 to specify the acceptable filing methods for a written review request of an initial order.

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.

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.

HCA is amending WAC 182-501-0135 to: (a) change the time period in which a client may request an administrative hearing from 90 days to 120 days, (b) state that HCA may determine on a case-by-case basis that a client may obtain certain prescription items at any pharmacy, and (c) add that HCA may remove a client from PRC placement if the client has successfully stabilized due to the utilization of treatment medications, including but not limited to, Buprenorphine.

The agency is revising this section to remove the information regarding telemedicine and add a cross reference to new rules that the agency is developing for audio-only telemedicine, in alignment with ESSB 1196. The new audio-only rules will reside in new section WAC 182-501-0300 and is being developed under a different rulemaking filed under WSR 21-15-065. The agency is removing this information from various chapters in Title 182 and creating this one-stop shop rule for audio-only telemedicine.

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.

The agency is amending WAC 182-509-0320 and WAC 182-512-0860 to include the working families’ tax credit under RCW 82.08.0206 as income that the agency excludes when determining eligibility for modified adjusted gross income (MAGI)-based Washington apple health and Washington apple health SSI-related medical programs.

The agency is correcting cross-references to repealed rules that were inadvertently not corrected at the time those rules were repealed. The agency is deleting WAC 182-508-0001(3)(d) and WAC 182-509-0001(2)(d) because the income limit to which they refer ceased to exist on January 1, 2020, and WAC 182-511-1060 was repealed under WSR 19-23-063. The agency is replacing references to WAC 182-513-1305 with references to WAC 182-513-1205 because the information that had been in WAC 182-513-1305 was revised and recodified in WAC 182-513-1205 and WAC 182-513-1305 was repealed under WSR 17-03-116. The agency is replacing references to WAC 182-514-0255 with references to WAC 182-514-0263 because WAC 182-514-0255 was repealed under WSR 16-04-087. The agency is deleting WAC 182-519-0100(1)(c) because the programs to which it refers ended in 2012 and WACs 182-515-1540 and 182-515-1550 were repealed under WSR 17-22-060.

The agency is correcting cross-references to a repealed rule and an outdated reference to an agency program. The agency is replacing references to WAC 182-532-0720 with references to chapter 182-532 WAC because that rule was repealed under WSR 19-18-024. The agency is replacing instances of the term TAKE CHARGE with current program terminology, specifically the Family Planning Only programs under chapter 182-532 WAC.

The agency is adding the 1915i income disregard equal to the difference between 150% of the Federal Poverty Level and 300% of the Federal Benefit Rate. This disregard is targeted to individuals seeking Community Behavioral Health Services.