Apple Health (Medicaid) rulemaking

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

Medical Assistance definitions - N
Affected WAC: 182-500-0075
Description: The agency is amending this rule as a result of federal regulations published February 2016 under 42 C.F.R. Part 440. The agency is adding a definition for “nonphysician practitioners,” a term which will be used in two WAC chapters to be amended in separate rulemaking actions as a result of the February 2016 federal regulations. The agency previously filed a Preproposal Statement of Inquiry in 2016 to begin rulemaking on this and other sections under WSR 16-11-094. The agency subsequently withdrew the previously filed Preproposal Statement of Inquiry under WSR 18-05-031 and is rewriting the proposed rule.
Agency contact:
Melinda Froud, rule writer
360-725-1408
Preproposal (CR101) - WSR 18-05-066
Filed 2/16/18
Proposal (CR102) - WSR 18-19-102
Hearing date: 10/23/18
*Comments due by COB
Permanent Adoption (CR103P) - WSR 18-24-023
Effective: 1/1/19
Dental-related services—Medical care services clients
Affected WAC: 182-535-1066
Description: Effective January 1, 2020, a medical care services (MCS) client may receive the same dental coverage in Chapter 182-535 WAC as other eligible clients. The agency is repealing WAC 182-535-1066 which contains limited dental coverage for MCS clients. This section will no longer apply.
Agency contact:
Valerie Smith, rule writer
360-725-1344
Preproposal (CR101) - WSR 19-18-071
Filed date: 9/3/19
Orthodontic treatment and orthodontic-related services
Affected WAC: 182-535A-0040, 182-535A-0050, 182-535A-0060
Description: The agency is revising these sections to clarify covered services and payment methodology.
Agency contact:
Valerie Smith, rule writer
360-725-1344
Preproposal (CR101) - WSR 19-14-116
Filed: 7/3/19
Eligible provider types
Affected WAC: 182-502-0002
Description: The agency is amending this section to add Dental Health Aide Therapists (DHAT) to the list of eligible providers who can be reimbursed for providing services to medicaid clients in tribal facilities. During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 19-13-056
Filed: 6/14/19
Emergency Adoption (CR103E) - WSR 19-14-058
Effective: 7/1/19-10/29/19
Proposal (CR102) - WSR 19-17-083
Hearing date 09/24/19
*Comments due by COB 09/24/19
Removing MCO Option
Affected WAC: 182-535-1050, 182-535-1060, 182-535-1245, 182-535A-0010, 182-535A-0020
Description: The agency is striking all references to dental managed care from these sections. Eligible clients will continue to receive their dental services through fee-for-service on and after July 1, 2019.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 19-12-035
Filed: 5/29/19
Emergency Adoption (CR103E) - WSR 19-14-054
Effective: 7/1/19-10/29/19
Proposal (CR102) - WSR 19-17-037
Hearing date: 9/24/19
*Comments due 9/24/19
Dental-related services and Orthodontic services
Affected WAC: 182-535-1050, 182-535-1060, 182-535A-0010, 182-535A-0020
Description: Recently signed ESHB 1109 directs the agency to not proceed with a managed care dental option, effective July 1, 2019. The agency previously revised these sections in anticipation of having a managed care dental option, effective July 1, 2019, to comply with SSB 5883 (Laws of 2017). This rulemaking strikes the dental managed care option.
Agency contact:
Michael Williams, rule writer
360-725-1346
Expedited Adoption (CR105) - WSR 19-11-119
Filed: 5/22/19
Withdrawal (CR105) - WSR 19-12-027
Effective: 5/29/19
Dental-related services - Covered - Oral and maxillofacial surgery services
Affected WAC: 182-535-1066, 182-535-1094
Description: The agency is revising this section to reflect changes in covered benefits, and to remove certain authorization requirements to expedite claims processing and the delivery of timely services.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 18-20-066
Filed: 9/27/18
Proposal (CR102) - WSR 19-01-074
Hearing date: 1/22/19
*Comments due by COB
Permanent Adoption (CR103P) - WSR 19-06-003
Effective: 3/24/19
Orthodontic treatment
Affected WAC: 182-535A-0040, 182-535A-0060
Description: The agency is revising these sections to clarify terms of coverage for orthodontic services. During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 18-20-013
Filed: 9/20/18
Proposal (CR102) - WSR 19-07-050
Hearing date: 4/23/19
*Comments due by 4/23/19
Permanent Adoption (CR103P) - WSR 19-11-028
Effective: 7/1/19
Access to Baby & Child Dentistry
Affected WAC: 182-535-1245
Description: The agency is revising WAC 182-535-1245 to expand the ABCD program to include children ages 6-12 with disabilities and allow for dentists and dental hygienists who are certified to provide program services to children with disabilities to be paid at the enhanced rate for these children. During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 18-10-113
Date Filed: 5/2/18
Withdrawal (CR101) - WSR 19-14-085
Filed: 7/1/19
Dental related services: Orthodontic services
Affected WAC: 182-535-1050, 182-500-0070, 182-535-1060, 182-535-1080, 182-535-1082, 182-535-1084, 182-535-1098, 182-535-1245, 182-535A-0010, 182-535A-0020
Description: The agency is revising these rules to comply with legislation in Substitute Senate Bill 5883 for providing dental services through managed care. The agency is also adding language in Chapter 182-535 WAC for the coverage of teledentistry, as already allow under WAC 182-531-1730.
Agency contact:
Vance Taylor, rule writer
360-725-1344
Preproposal (CR101) - WSR 18-07-089
Filed: 3/20/18
Proposal (CR102) - WSR 18-17-187
Hearing date: 9/25/18
*Comments due by COB
Supplemental (CR102) - WSR 19-06-044
Hearing date: 4/9/19
*Comments due 4/9/19
Permanent Adoption (CR103P) - WSR 19-09-058
Effective: 7/1/19

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