Apple Health (Medicaid) rulemaking
This page includes all of the current rule making activity for Washington Apple Health (Medicaid)
Rule making activities
Medical Equipment & Supplies
Affected WACs
182-543-4000,
182-543-4100,
182-543-5700
Description
The agency is amending these rules to clarify and update the coverage criteria for medical equipment for clients who receive Medicaid-funded care in nursing facilities and other housekeeping changes.
Agency contacts
Rulemaking contact
Valerie Freudenstein
Program contact
Sunpreet Bhangoo
Rulemaking status history
Preproposal (CR101)
- WSR 25-12-099
- Date Filed: 6/4/2025
DME/CRT/P&O, medical supplies and related services - Eligible providers and provider requirements
Affected WACs
182-543-2000
Description
The agency is amending WAC 182-543-2000 to amend the medical equipment and supplies provider requirements.
Agency contacts
Rulemaking contact
Brian Jensen
Program contact
Dani Crawford
Rulemaking status history
Preproposal (CR101)
- WSR 24-24-085
- Filed: 12/02/2024
Proposal (CR102)
- WSR 25-04-044
- Hearing Date: 3/11/2025
- Comments due by 3/11/2025
Permanent Adoption (CR103P)
- WSR 25-07-045
- Effective: 5/1/2025
Medical supplies and services - Proof of delivery
Affected WACs
182-543-2200
Description
HCA is amending this rule to clarify requirements for proof of delivery of all medical equipment and supplies.
Agency contacts
Rulemaking contact
Jason Crabbe
Program contact
Dani Crawford
Rulemaking status history
Preproposal (CR101)
- WSR 24-16-093
- Filed: 8/1/2024
Withdrawal (CR101)
- WSR 24-17-045
- Withdrawn: 8/14/2024
Preproposal (CR101)
- WSR 24-17-065
- Filed: 8/15/2024
Osteogenesis electrical stimulator
Affected WACs
182-543-3300
Description
The agency is amending WAC 182-543-3300. Rule updates will include updated medical necessity criteria based on evidence review(s).
Agency contacts
Rulemaking contact
Brian Jensen
Program contact
Dani Crawford
Rulemaking status history
Preproposal (CR101)
- WSR 24-10-047
- Filed: 4/24/2024
Proposal (CR102)
- WSR 24-14-013
- Hearing date 8/6/2024
- Comments due by 8/6/2024
Permanent Adoption (CR103P)
- WSR 24-17-001
- Effective: 9/8/2024
MSE Definitions
Affected WACs
182-543-1000
Description
The agency is amending this rule to update medical equipment, supplies, & appliances definitions to align with industry standard.
Agency contacts
Rulemaking contact
Valerie Freudenstein
Program contact
Dani Crawford
Rulemaking status history
Preproposal (CR101)
- WSR 24-09-006
- Filed: 4/4/2024
Proposal (CR102)
- WSR 24-14-039
- Hearing date 8/6/2024
- Comments due by 8/6/2024
Permanent Adoption (CR103P)
- WSR 24-18-019
- Effective: 9/23/2024
Covered Hospital Beds and Authorization
Affected WACs
182-543-3000,
182-543-7000
Description
HCA is amending these rules to change the medical necessity criteria for hospital beds and to clarify the process for submitting prior authorization requests to HCA.
Agency contacts
Rulemaking contact
Jason Crabbe
Program contact
Dani Crawford
Rulemaking status history
Preproposal (CR101)
- WSR 24-07-007
- Filed: 3/7/2024
Medical equipment for clients in skilled nursing facilities
Affected WACs
182-543-5700
Description
The agency amended WAC 182-543-5700 to correct the number for a form titled Medical Necessity for Wheelchair
Purchase for Nursing Facility Clients. The correct form number is HCA 19-0006.
Purchase for Nursing Facility Clients. The correct form number is HCA 19-0006.
Agency contacts
Rulemaking contact
Brian Jensen
Rulemaking status history
Expedited Adoption (CR105)
- WSR 24-05-029
- Filed: 2/12/2024
- Comments due by 4/23/2024
Permanent Adoption (CR103P)
- WSR 24-10-041
- Effective 5/25/2024
Reimbursement regarding compounded prescriptions and the automated maximum allowable cost
Affected WACs
182-530-7150,
182-530-8150
Description
HCA is removing all instances of “automated maximum allowable cost” and “AMAC” from WAC 182-530-7150 and repealing WAC 182-530-8150. HCA is no longer using AMAC as a reimbursement method.
Agency contacts
Rulemaking contact
Brian Jensen
Program contact
Wendy Steffens
Rulemaking status history
Preproposal (CR101)
- WSR 24-11-004
- Filed: 5/2/2024
Proposal (CR102)
- WSR 24-19-032
- Hearing Date: 10/22/2024
- Register to attend the public hearing: Registration is required
- Comments due by 10/22/2024
Permanent Adoption (CR103P)
- WSR 24-22-005
- Effective: 11/23/2024
Rules pertaining to the 340B program
Affected WACs
182-530-1050,
182-530-7000,
182-530-7250,
182-530-7300,
182-530-7900,
182-530-8000,
182-530-8100,
182-531-0050,
182-531-1200,
182-531-1450
Description
HCA is amending these rules to add clarity and provide more detail on program requirements for how fee-for-service drugs must be billed to HCA for providers that are subject to the 340B program requirements.
Agency contacts
Rulemaking contact
Jason Crabbe
Program contact
Natalia Oxford Wilson
Rulemaking status history
Preproposal (CR101)
- WSR 23-07-015
- Filed: 3/3/2023
Proposal (CR102)
- WSR 24-05-054
- Hearing date 3/26/2024
- Comments due by 3/26/2024
Permanent Adoption (CR103P)
- WSR 24-08-061
- Effective: 5/1/2024
Provider types - Certified peer specialist, psychological associate
Affected WACs
182-502-0002,
182-531-0425,
182-531-1400,
182-531-1710,
182-538D-0200
Description
HCA is amending these rules to add the following provider types: Certified Peer Specialist, Certified Peer Specialist Trainee, and Psychological Associate.
Agency contacts
Rulemaking contact
Jason Crabbe
Program contact
Susan Mathey
Rulemaking status history
Preproposal (CR101)
- WSR 25-12-103
- Date Filed: 6/4/2025
Withdrawal (CR101)
- WSR 25-14-123
- Withdrawal: 7/2/2025