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Apple Health (Medicaid) rulemaking

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

Covered OP drugs, devices, and drug-related supplies
Affected WAC: 182-530-2000
Emergency rules adopted
WSR 20-08-118
Description: The agency is replacing the list of covered generic products for the treatment of cough and cold. Under the amended rule, the agency instead covers only those products with a preferred status on the Medicaid preferred drug list (PDL) on the date a prescription is dispensed.
Agency contact:
Melinda Froud, rule writer
360-725-1408
Emergency Adoption (CR103E) - WSR 20-08-118
Effective: 3/31/2020-7/29/2020
Billing Requirements - pharmacy claim payment
Affected WAC: 182-530-5000
Emergency rules adopted
WSR 20-08-106
Description: The Health Care Authority is temporarily removing the requirement to obtain a signature from the Medicaid client or the client’s designee upon receipt of pharmacy products dispensed and delivered directly to a client.
Agency contact:
Melinda Froud, rule writer
360-725-1408
Emergency Adoption (CR103E) - WSR 20-08-106
Effective: 3/31/2020 - 7/29/2020
Proof of delivery
Affected WAC: 182-543-2200
Emergency rules adopted
WSR 20-08-025
Description: The Health Care Authority is revising this section to temporarily eliminate the requirement for date and signature from the Medicaid client or the client’s designee upon delivery of medical equipment and supplies.
Agency contact:
Valerie Freudenstein, rule writer
360-725-1344
Emergency Adoption (CR103E) - WSR 20-08-025
3/20/2020-7/18/2020
Children's Washington apple health with premiums
Affected WAC: 182-505-0215
Formally proposed
WSR 19-21-103
Description: During the 2017 legislative session, the Washington State Legislature passed Engrossed House Bill (EHB) 2242 which created the School Employees’ Benefits Board (SEBB) health insurance benefit beginning January 1, 2020. The availability of this benefit, beginning January 1, 2020, means these children no longer meet the definition of targeted low income children under 42 CFR 357.310, and will not be eligible for the Children’s Health Insurance Program (CHIP), also known as Washington Apple Health with Premiums Program.
Agency contact:
Valerie Freudenstein, rule writer
360-725-1344
Preproposal (CR101) - WSR 19-13-058
Filed: 6/14/19
Proposal (CR102) - WSR 19-18-066
Hearing date: 10/8/19
*Comments due by 10/8/19
Permanent Adoption (CR103P) - WSR 19-21-103
Effective: 1/1/2020
Program Integrity
Affected WAC: 182-502A-0101, 182-502A-0201, 182-502A-0301, 182-502A-0401, 182-502A-0501, 182-502A-0601, 182-502A-0701, 182-502A-0801, 182-502A-0901, 182-502A-1001, 182-502A-1101
Formally proposed
WSR 20-02-100
Description: The agency is amending this chapter to clarify and revise language to align with federal and state regulations.
Agency contact:
Melinda Froud, rule writer
360-725-1408
Preproposal (CR101) - WSR 19-08-089
Filed date: 4/3/19
Proposal (CR102) - WSR 19-23-096
Hearing date: 12/24/19
*Comments due by 12/24/19
Permanent Adoption (CR103P) - WSR 20-02-100
Effective: 1/31/2020
Wraparound and Intensive Services (WISe)
Affected WAC: 182-501-0215
Accepting comments
WSR 20-09-014
Description: This rulemaking is required to comply with and provide ongoing guidance related to the requirements that ensure the quality of the WISe service delivery model.
Agency contact:
Valerie Freudenstein, rule writer
360-725-1344
Preproposal (CR101) - WSR 19-15-146
Filed date: 7/24/19
Proposal (CR102) - WSR 20-09-014
Hearing date: 5/26/2020
*Comments due by 5/26/2020
Advance Directives
Affected WAC: 182-501-0125
Pending formal proposal
WSR 19-06-029
Description: The agency is amending this rule to update and replace references to health maintenance organizations (HMOs) with current terminology.
Agency contact:
Melinda Froud, rule writer
360-725-1408
Preproposal (CR101) - WSR 19-06-029
Date Filed: 2/28/19
Alien Emergency Medical (AEM) program
Affected WAC: 182-507-0115
Emergency rules adopted
WSR 20-07-082
Description: The Health Care Authority is revising this section to allow for payment of office visits for clients under the Alien Emergency Medical (AEM) program when the visit is specifically for the assessment and treatment of the COVID-19 virus.
Emergency Adoption (CR103E) - WSR 20-07-082
Effective: 3/16/2020-7/14/2020
Evaluating an asset transfer, trusts, annuities
Affected WAC: 182-513-1363, Chapter 182-516
Pending formal proposal
WSR 20-06-065
Description: The agency is amending these sections to provide clarity that certain asset transfers can still cause a penalty, even if compensation is made.
Agency contact:
Valerie Freudenstein, rule writer
360-725-1344
Preproposal (CR101) - WSR 20-06-065
Filed date: 3/3/2020
Asset verification system
Affected WAC: 182-503-0055
Pending formal proposal
WSR 20-06-063
Description: The agency is revising subsection (4) to clarify who may authorize for asset verification.
Agency contact:
Valerie Freudenstein, rule writer
360-725-1344
Preproposal (CR101) - WSR 20-06-063
Filed date: 3/3/2020

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