Apple Health (Medicaid) rulemaking

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

Rule making activities

Description
RCW 74.09.830 provides full-scope coverage for 12 months postpartum for pregnant or postpartum persons. This coverage is more generous than and thus replaces the limited scope “Family planning only – Pregnancy related program.” The agency intends to remove language related to this superseded program from chapter 182-532 WAC.

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Melissa Rivera

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending this chapter to clarify rules for RHCs applying for a change in scope rate adjustment and an interim-rate to final-rate adjustment. Additionally, the agency plans to add detailed clarification to the rules regarding adding dental services to an RHC through a change in scope application.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Patrick Miles

Rulemaking status history

Preproposal (CR101)

Description
The agency is adding a new section describing system requirements for electronic visit verification (EVV) for home health care services.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Greg Sandoz

Rulemaking status history

Preproposal (CR101)

Agency contacts

Rulemaking contact

Melinda Froud

Program contact

Lisa Little

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is revising these rules to allow for reimbursements of professional services for home infusions.

Agency contacts

Rulemaking contact

Melinda Froud

Program contact

Fawn Ross

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Description
The agency is amending these rules as the payments for outlier enhancements have exceeded the budget neutral amount calculated during the 2021 hospital rebasing period. An increase in the outlier threshold will allow the state to bring payments more in line with the budget neutral total calculated in 2021.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Abby Cole

Rulemaking status history

Preproposal (CR101)

Description
Updating chemical-using pregnant (CUP) women to substance-using pregnant people (SUPP). The revision allows for alignment with agency standard language.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Melissa Craig

Rulemaking status history

Expedited Adoption (CR105)

Permanent Adoption (CR103P)

Description
The agency is amending these rules to remove reference to “other medical necessary services” to align with SHB 2051.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Abby Cole

Rulemaking status history

Preproposal (CR101)

Emergency Adoption (CR103E)

  • WSR 25-15-120
  • Effective: 8/1/2025-11/18/2025
  • CR101 WSR 25-13-064 Filed 6/13/2025

Proposal (CR102)

Description
The agency is striking outdated subsection citations in WAC 182-550-5000 and striking the definition of DSH reporting data file (DRDF) in WAC 182-550-4900 as it is no longer applicable and is a term that is not used within the chapter. These changes clarify the rules without changing their effect.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Mary O'Hare

Rulemaking status history

Expedited Adoption (CR105)

Permanent Adoption (CR103P)

Description
To clarify language without changing the rules effect. Updating method of notice from first class mail to email. This revision allows for quicker
notification to providers and is less costly.

Agency contacts

Rulemaking contact

Wendy Barcus

Program contact

Tracy Huynh

Rulemaking status history

Expedited Adoption (CR105)

Permanent Adoption (CR103P)