Partial federal government shutdown
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
Apple Health (Medicaid) rulemaking
This page includes all of the current rule making activity for Washington Apple Health (Medicaid)
Rule making activities
Apple Health Expansion
Affected WACs
182-500-0120,
182-501-0060,
182-501-0065,
182-503-0510,
182-503-0515,
182-503-0535,
182-509-0220,
182-525,
182-525A,
182-525B,
182-526-0005
Description
The agency is developing rules under ESSB 5187 Sec. 211 (83), 68th Legislature, 2023 Regular Session. This legislation directs the agency to implement a program with coverage comparable the categorically needy Medicaid program for certain adults age 19 and older who: (a) have an immigration status making them ineligible for Medicaid or federal subsidies through the Health Benefit Exchange; and (b) are not eligible for another full scope federally funded medical assistance program.
Agency contacts
Rulemaking contact
Melinda Froud
Program contact
Annette Schuffenhauer
Rulemaking status history
Emergency Adoption (CR103E)
- WSR 24-13-067
- Effective: 6/17/2024 - 10/10/2024
Emergency Adoption (CR103E)
- WSR 24-21-064
- Effective 10/11/2024 - 2/6/2025
Emergency Adoption (CR103E)
- WSR 25-02-112
- Effective: 1/2/2025 - 2/6/2025
Emergency Adoption (CR103E)
- WSR 25-05-014
- Effective: 2/7/2025 - 6/5/2025
Emergency Adoption (CR103E)
- WSR 25-13-013
- Effective: 6/6/2025-10/1/2025
Emergency Adoption (CR103E)
- WSR 25-21-010
- Effective: 10/2/2025 - 1/30/2026
Preproposal (CR101)
- WSR 23-14-063
- Filed: 6/28/2023
Dental-related services – covered – oral and maxillofacial surgery services
Affected WACs
182-535-1094
Description
The agency is revising this rule to remove age specific language in subsection (3)(c) and remove subsection (3)(d) to make it less prescriptive and align with HCA’s Health Technology Clinical Committee (HTCC) decision findings. Additionally, the agency is updating the developmental disabilities administration name to align with the name change initiated by the department of social and health services.
Agency contacts
Rulemaking contact
Valerie Freudenstein
Program contact
Jayson Diaz
Rulemaking status history
Preproposal (CR101)
- WSR 25-17-012
- Filed: 8/8/2025
Proposal (CR102)
- WSR 25-21-017
- Hearing Date: 11/25/25
- Register to attend the public hearing: Registration is required
- Comments Due: 11/25/25
Dental therapists
Affected WACs
182-535-1070
Description
The agency is amending these rules to add dental therapists as an eligible provider type.
Agency contacts
Rulemaking contact
Valerie Freudenstein
Program contact
Jayson Diaz
Rulemaking status history
Preproposal (CR101)
- WSR 25-06-041
- Filed: 2/27/2025
Proposal (CR102)
- WSR 25-09-094
- Hearing Date: 5/27/2025
- Register to attend the public hearing: Registration is required
- Comments due by 5/27/2025
Permanent Adoption (CR103P)
- WSR 25-12-065
- Effective: 6/30/2025
Income standards for pregnancy and postpartum groups
Affected WACs
182-505-0100,
182-509-0305
Description
The agency is amending its rules to increase the income standards for pregnancy and postpartum groups from 193% to 210% of the federal poverty level. This
increase is consistent with legislative directives in chapter 213, Laws of 2024 (2E2SSB 5580).
increase is consistent with legislative directives in chapter 213, Laws of 2024 (2E2SSB 5580).
Agency contacts
Rulemaking contact
Brian Jensen
Program contact
Kristina Bair
Rulemaking status history
Preproposal (CR101)
- WSR 24-13-063
- Filed: 6/13/2024
Proposal (CR102)
- WSR 24-16-113
- Hearing Date: 9/10/2024
- Comments due by 9/10/2024
Permanent Adoption (CR103P)
- WSR 24-19-037
- Effective: 11/1/2024
Birth Doula
Affected WACs
182-533-0610,
182-533-0620,
182-533-0630,
182-533-0640,
182-533-0650,
182-533-0660,
182-533-0665,
182-533-0670,
182-533-0680
Description
The State Supplemental Operating budget (section 211 (34), Chapter 376, Laws of 2024, (ESSB 5950)), included funding for the Health Care Authority (HCA) to implement a birth doula benefit for Apple Health (Medicaid) clients. HCA is developing rules in Chapter 182-533 WAC and amending WAC 182-502-0002 to accomplish this.
Agency contacts
Rulemaking contact
Jason Crabbe
Program contact
Michelle Madrigal
Rulemaking status history
Preproposal (CR101)
- WSR 24-10-016
- Filed: 4/19/2024
Emergency Adoption (CR103E)
- WSR 25-02-111
- Effective: 01/01/2025 - 4/29/2025
Emergency Adoption (CR103E)
- WSR 25-10-037
- Effective: 4/30/2025 - 8/24/2025
Proposal (CR102)
- WSR 25-13-066
- Hearing Date: 7/22/2025
- Register to attend the public hearing: Registration is required
- Comments due by 7/22/2025
Permanent Adoption (CR103P)
- WSR 25-16-016
- Effective: 8/25/2025
Family Planning Only Services, Payment, and Documentation
Affected WACs
182-532-500,
182-532-001,
182-532-520,
182-532-530,
182-532-550,
182-532-560,
182-532-570
Description
The agency is amending this rule to expand screening and preventative services for certain sexually transmitted infections during a client visit focused on family planning.
Agency contacts
Rulemaking contact
Melinda Froud
Program contact
Andrea Estes
Rulemaking status history
Preproposal (CR101)
- WSR 23-23-184
- Filed: 11/22/2023
Withdrawal (CR101)
- WSR 23-24-064
- Effective: 12/4/2023
Emergency Adoption (CR103E)
- WSR 24-02-058
- Effective: 1/1/2024 - 4/27/2024
Emergency Adoption (CR103E)
- WSR 24-10-058
- Effective: 4/27/2024 - 8/23/2024
Emergency Adoption (CR103E)
- WSR 24-18-018
- Effective: 8/24/2024 - 12/19/2024
Emergency Adoption (CR103E)
- WSR 25-02-046
- Effective: 12/20/2025 - 4/17/2025
Emergency Adoption (CR103E)
- WSR 25-09-097
- Effective: 4/18/2025 - 8/14/2025
Emergency Adoption (CR103E)
- WSR 25-17-057
- Effective: 8/15/2025 - 12/13/2025
Preproposal (CR101)
- WSR 23-24-065
- Filed: 12/04/2024
Proposal (CR102)
- WSR 25-20-110
- Hearing Date: 11/4/2025
- Register to attend the public hearing: Registration is required
- Comments Due: 11/4/2025
Family Planning Only programs - Eligibility
Affected WACs
182-532-001,
182-532-510
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)
- WSR 23-16-017
- Filed: 7/20/2023
Proposal (CR102)
- WSR 24-18-075
- Hearing Date: 10/08/2024
- Comments due by 10/08/2024
Permanent Adoption (CR103P)
- WSR 25-06-057
- Effective: 3/31/2025
Rural Health Clinics (RHCs) - change in scope/rate adjustment
Affected WACs
Chapter 182-549 WAC
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)
- WSR 25-12-070
- Date filed: 5/30/2025
Electronic visit verification
Affected WACs
182-551-2230
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)
- WSR 24-05-023
- Filed: 2/12/2024
Hospice Services - Subchapter 1
Affected WACs
182-551-1000,
182-551-1010,
182-551-1200,
182-551-1210,
182-551-1300,
182-551-1305,
182-551-1310,
182-551-1315,
182-551-1320,
182-551-1330,
182-551-1340,
182-551-1350,
182-551-1360,
182-551-1370,
182-551-1400,
182-551-1500,
182-551-1510,
182-551-1520,
182-551-1530,
182-551-1810,
182-551-1820,
182-551-1830,
182-551-1840,
182-551-1860
Agency contacts
Rulemaking contact
Melinda Froud
Program contact
Lisa Little
Rulemaking status history
Preproposal (CR101)
- WSR 24-20-101
- Filed: 9/30/2024
Proposal (CR102)
- WSR 25-12-037
- Hearing Date: 7/8/2025
- Register to attend the public hearing: Registration is required
- Comments due by 7/8/2025
Permanent Adoption (CR103P)
- WSR 25-16-015
- Effective: 9/1/2025