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Apple Health (Medicaid) rulemaking

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

Patient review and coordination (PRC)
Affected WAC: 182-501-0135
Formally proposed
Effective: 5/8/2021
Description: The agency is revising this section to clarify that a client with private full coverage insurance is not reviewed or placed into the Patient Review and Coordination (PRC) program unless the client does not have pharmacy coverage. In this situation, if the client qualifies for PRC and is placed into the PRC program, the restriction is only to a pharmacy.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 20-22-041
Filed date: 10/28/2020
Proposal (CR102) - WSR 21-05-037
Withdrawal (CR102) - WSR 21-06-013
Effective: 2/29/21
Proposal (CR102) - WSR 21-06-064
Hearing date: 4/6/2021
*Comments due by 4/6/2021
Permanent Adoption (CR103P) - WSR 21-08-090
Effective: 5/8/2021
Washington Apple Health Exception to Rule
Affected WAC: 182-503-0090
Formally proposed
Effective: 3/1/2021
Description: The agency is amending WAC 182-503-0090 to specify the Department of Social and Health Services administrations responsible for processing exceptions to rule related to long-term services and supports programs. The agency is also making nonsubstantive changes for consistency with other agency rules.
Agency contact:
Brian Jensen, rule writer
360-725-0815
Preproposal (CR101) - WSR 20-21-013
Filed date: 10/09/2020
Proposal (CR102) - WSR 21-01-044
Hearing Date: 1/26/2021
*Comments due by 1/26/2021
Permanent Adoption (CR103P) - WSR 21-04-076
Effective: 3/1/2021
Personal needs allowance (PNA) and room and board standards in a medical institution and ALF
Affected WAC: 182-513-1105
Formally proposed
Effective: 2/6/2021
Description: The agency is amending these rules to increase the personal needs allowance from $70.00 to $71.12 effective January 1, 2021. Funding is approved for this increase which affects those receiving long-term services and supports in medical institutions and alternate living facilities
Agency contact:
Valerie Freudenstein, rule writer
360-725-1344
Preproposal (CR101) - WSR 20-20-107
Filed date: 10/06/2020
Proposal (CR102) - WSR 20-24-035
Hearing Date: 1/5/2021
*Comments due by 1/5/2021
Permanent Adoption (CR103P) - WSR 21-02-086
Effective: 2/6/2021
Children's Washington apple health with premiums
Affected WAC: 182-505-0215
Formally proposed
Effective: 1/23/2021
Description: The agency is amending WAC 182-505-0215 to expand the Children’s Health Insurance Program to include coverage for eligible children of public employees.
Agency contact:
Brian Jensen, rule writer
360-725-0815
Emergency Adoption (CR103E) - WSR 20-19-106
Effective: 9/18/2020 - 1/04/2021
Preproposal (CR101) - WSR 20-19-107
Filed date: 9/18/2020
Proposal (CR102) - WSR 20-23-047
Hearing date: 12/22/2020
Comment due by: 12/22/2020
Emergency Adoption (CR103E) - WSR 21-02-076
Effective: 1/5/2021- 1/22/2021
Permanent Adoption (CR103P) - WSR 21-01-207
Effective: 1/23/2021
Refugee medical
Affected WAC: 182-507-0130
Formally proposed
Effective: 11/8/2020
Description: The agency is amending subsection (8) of WAC 182-507-0130 to specify circumstances under which an individual may receive additional months of refugee medical assistance benefits.
Agency contact:
Brian Jensen, rule writer
360-725-0815
Preproposal (CR101) - WSR 20-14-055
Filed date: 6/26/2020
Emergency Adoption (CR103E) - WSR 20-14-081
Effective: 6/30/20-10/22/20
Proposal (CR102) - WSR 20-18-059
Hearing date: 10/6/2020
*Comments due by 10/6/2020
Emergency Adoption (CR103E) - WSR 20-22-016
Effective; 10/23/20-11/07/20
Permanent Adoption (CR103P) - WSR 20-21-008
Effective: 11/8/2020
Lottery winnings and hardship exemptions
Affected WAC: 182-509-0325
Pending formal proposal
Filed date: 6/24/2020
Description: The agency is amending WAC 182-509-0325 to add certain lottery winnings as an example of unearned income; amending WAC 182-509-0375 to specify how certain lottery winnings impact eligibility for modified adjusted gross income-based Washington apple health; and creating a new WAC 182-509-0380 to establish lottery winnings hardship exemptions. The agency has determined this rulemaking is necessary to comply with federal law, 42 U.S.C. 1396a(e)(14)(K), and recent federal guidance applicable to it.
Agency contact:
Brian Jensen, rule writer
360-725-0815
Preproposal (CR101) - WSR 20-14-033
Filed date: 6/24/2020
Disregarded Income
Affected WAC: 182-521-0100
Emergency rules adopted
Effective: 09/03/2021
Description: The agency is establishing Chapter 182-521 WAC, titled Public Health Emergency Rules, and creating a new section under WAC 182-521-0100, Disregarded income, to identify income that the agency does not count when determining Apple Health eligibility.
Agency contact:
Jason Crabbe, rule writer
360-725-9563
Emergency Adoption (CR103E) - WSR 20-13-013
Effective: 6/5/2020 - 10/1/2020
Preproposal (CR101) - WSR 20-15-141
Date file: 07/21/2020
Emergency Adoption (CR103E) - WSR 20-20-075
Effective: 10/2/2020-1/28/2021
Emergency Adoption (CR103E) - WSR 21-04-074
Effective: 1/29/2021 - 5/05/2021
Emergency Adoption (CR103E) - WSR 21-11-002
Effective: 05/06/2021-08/26/2021
Proposal (CR102) - WSR 21-18-079
Hearing date: 10/05/2021
*Comments due 10/05/2021
Emergency Adoption (CR103E) - WSR 21-19-011
Effective: 09/03/2021
Alien Emergency Medical (AEM) program
Affected WAC: 182-507-0115, 182-507-0120
Accepting comments
Hearing date: 07/27/2021
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.
Agency contact:
Brian Jensen, rule writer
360-725-0815
Emergency Adoption (CR103E) - WSR 20-07-082
Effective: 03/16/2020-07/12/2020
Emergency Adoption (CR103E) - WSR 20-15-069
Effective: 07/13/2020-11/04/2020
Preproposal (CR101) - WSR 20-15-077
Filed date: 7/14/2020
Emergency Adoption (CR103E) - WSR 20-23-003
Effective: 11/05/2020-03/03/2021
Emergency Adoption (CR103E) - WSR 21-07-007
Effective: 03/04/2021-07/01/2021
Emergency Adoption (CR103E) - WSR 21-14-070
Effective: 07/02/2021
Proposal (CR102) - WSR 21-13-049
Hearing date: 07/27/2021
*Comments due 07/27/2021
Evaluating an asset transfer
Affected WAC: 182-513-1363
Formally proposed
Effective: 8/1/2020
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
Proposal (CR102) - WSR 20-11-031
Virtual hearing date: 6/23/2020
*Comments due 6/23/2020
Permanent Adoption (CR103P) - WSR 20-14-120
Effective: 8/1/2020
Asset verification system
Affected WAC: 182-503-0055
Formally proposed
Effective date: 9/12/2020
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
Proposal (CR102) - WSR 20-14-113
Hearing date: 8/4/2020
*Comments due 8/4/2020
Permanent Adoption (CR103P) - WSR 20-17-061
Effective date: 9/12/2020