Apple Health (Medicaid) rulemaking

Description: The agency is amending this section to implement requirements in the Bipartisan Budget Act of 2018 which requires state Medicaid agencies to use cost-avoidance on labor, delivery, and postpartum care claims. The Bipartisan Budget Act of 2018 also delayed the implementation of a provision in the Bipartisan Budget Act of 2013 that allowed payment up to 90 days for claims associated with medical support enforcement, rather than 30 days under the previous law. The agency is revising this section to implement this provision, now amended to 100 days, rather than 90, by the Medicaid Services Investment and Accountability Act of 2019.

Description: The agency is amending these WACs to: 1) align income exemptions with the Internal Revenue Code; 2) clarify noncountable income provisions; and 3) remove provisions that are no longer applicable. Additionally, the agency is repealing three sections from Chapter 182-509 because: • MAGI programs do not count the income from employment and training described in WAC 182-509-0345. • Rules regarding needs-based assistance from other agencies or organizations set out in 182-509-0350 have been moved to 182-509-0320. • Gifts and inheritances listed in 182-509-0355 are already identified in 182-509-0320.

Description: HCA is amending these sections to correct outdated behavioral health terminology, to update references to correct state agencies and other minor housekeeping changes.

Description: The agency is amending these rules to extend the program through December 31, 2023, or until pilot funds are completely dispersed, whichever comes first. Additionally, age limits and dual eligibility exclusions are being removed. The enhanced rate will now include an additional periodic exam and adult prophylaxis as well as one fluoride varnish application, and one silver diamine fluoride treatment.

Description: The agency is amending these rules align with SSB 5976.

Description: The agency is amending these rules to remove all references to interceptive treatment. This change is necessary to align with the planned discontinuance of the CDT code for interceptive treatment, effective January 1, 2022 by the American Dental Association’s Council of Dental Benefit Program’s Code Maintenance Committee.

Description: The agency is amending these rules to: *Add and remove definitions. *Remove “including periodontal charting” from the comprehensive oral evaluation definition. *Remove diagnostic casts from covered diagnostic tests and examination. *Add “and implants” to prophylaxis covered services. *Remove tobacco cessation as a covered service under the Dental program. *Add “glass ionomer” to sealant covered preventative services. *Change limitations for replacement of restorations by clarifying “replacement of a cracked or broken restoration within a 6- month period by the same provider is considered part of the global payment of the initial restoration and will not pay separately.” *Change stainless steel crowns for permanent posterior teeth no longer have age limitations or require prior authorization. *Add clarification that all replacement dentures and replacement partial dentures require prior authorization and the need for the replacement must be medically necessary. *Add language for coverage of alveoloplasty to include “only in conjunction with the preparation of dentures or partials” and remove “prior authorization is not required.” *Add limitation for full mouth scaling to a 12-month period. *Change nondental providers to medical providers and other housekeeping updates as necessary.

Description: HCA is amending this rule to add the HPV vaccine as a covered service under the Family planning only program.

Description: The agency is amending this rule to replace "Chemical Dependency Professional" with "Substance Use Disorder Professional". This change aligns with RCW 18.205.020.

Description: ESSB 6168, Ch. 357, Sec. 211(32), Laws of 2020 requires the Health Care Authority (HCA) to reimburse maternity services provided by doulas.