Due to COVID-19, HCA’s lobby is closed. Learn more about HCA's customer service options during the pandemic.

Apple Health (Medicaid) rulemaking

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

Sterilization
Affected WAC: 182-531-1550
Formally proposed
Effective: 1/1/2021
Description: The agency is amending WAC 182-531-1550 to remove subsection (5), which describes the circumstances under which the agency waives the 30-day consent waiting period for sterilization. The agency has determined this rule amendment is necessary to align with federal rule, specifically 42 CFR sections 50.203(d) and 50.204(7)(e)(1).
Agency contact:
Brian Jensen, rule writer
360-725-0815
Preproposal (CR101) - WSR 20-13-085
Filed date: 6/16/2020
Proposal (CR102) - WSR 20-17-041
Hearing Date: 9/22/2020
*Comments due by 9/22/2020
Permanent Adoption (CR103P) - WSR 20-20-010
Effective: 1/1/2021
Family planning only programs - Eligibility
Affected WAC: 182-532-510
Formally proposed
Effective: 11/09/2020
Description: The agency is intending to establish rules to comply with ESHB 1109, Sec 211 (47), which provides funding for services identical to those services covered by the Washington state family planning waiver program to individuals who: (1) Are age 20 and older; (2) Who are at or below 260% of the federal poverty level; (3) Who are not covered by public or private insurance; and (4) Who need family planning services and are not currently covered by or eligible for another medical assistance program for family planning.
Agency contact:
Jason Crabbe, rule writer
360-725-9563
Preproposal (CR101) - WSR 19-21-038
Filed date: 10/08/19
Emergency Adoption (CR103E) - WSR 20-02-098
Effective: 1/1/2020 - 4/26/2020
Emergency Adoption (CR103E) - WSR 20-10-020
Effective: 4/27/2020-8/31/2020
Proposal (CR102) - WSR 20-09-096
Hearing date: Cancelled
Proposal (CR102) - WSR 20-10-110
Hearing date: 6/23/2020
*Comments due 6/23/2020
Emergency Adoption (CR103E) - WSR 20-18-073
Effective: 9/1/2020-12/30/2020
Permanent Adoption (CR103P) - WSR 20-21-024
Effective: 11/09/2020
FQHC & RHC - General payment information
Affected WAC: Chapter 182-548, Chapter 182-549
Formally proposed
Effective: 1/1/2021
Description: The agency is amending these chapters to replace fee-for-service equivalency language with actual managed care payments language. The agency may consider other amendments to these chapters during the rulemaking process.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 20-04-072
Filed: 2/3/2020
Proposal (CR102) - WSR 20-19-076
Virtual hearing date: 10/27/2020
*Comments due by 10/27/2020
Permanent Adoption (CR103P) - WSR 20-24-083
Effective: 1/1/2021
Practitioners authorized to order certain medical equipment and home health services
Affected WAC: 182-543-2000, 182-551-2010, 182-551-2210
Accepting comments
Hearing date: 10/26/2021
Description: HCA is amending these rules to change occurrences of “ordering physician” to “authorized practitioner” to align with amendments in Chapters 182-543 and 182-551 WAC recently made in WSR 21-12-051.
Agency contact:
Jason Crabbe, rule writer
360-725-9563
Preproposal (CR101) - WSR 21-14-007
Filed date: 6/24/2021
Proposal (CR102) - WSR 21-19-156
Hearing date: 10/26/2021
*Comments due 10/26/2021
DME & Home Health - ARNPs PAs Ordering
Affected WAC: 182-543-0500, 182-551-2040
Formally proposed
Effective date: 06/26/2021
Description: The agency is amending WAC 182-543-0500 and WAC 182-551-2040 to allow ordering of home health services, including medical supplies, by nonphysician practitioners.
Agency contact:
Jason Crabbe, rule writer
360-725-9563
Emergency Adoption (CR103E) - WSR 20-09-016
Effective: 4/3/2020-7/29/2020
Preproposal (CR101) - WSR 20-11-075
Filed date: 5/20/2020
Emergency Adoption (CR103E) - WSR 20-16-083
Effective: 7/30/2020-11/27/2020
Emergency Adoption (CR103E) - WSR 21-01-002
Effective: 12/2/2020-3/29/2021
Proposal (CR102) - WSR 21-06-100
Hearing date: 4/6/2021
*Comments due 4/6/2021
Emergency Adoption (CR103E) - WSR 21-08-026
Effective: 3/30/2021-06/25/2021
Supplemental (CR102) - WSR 21-09-084
Hearing date: 05/25/2021
*Comments due 05/25/2021
Permanent Adoption (CR103P) - WSR 21-12-051
Effective date: 06/26/2021
Hospitals and units exempt from the DRG payment method
Affected WAC: 182-550-4300
Pending formal proposal
Filed date: 09/27/2021
Description: The agency is amending WAC 182-550-4300(5) to align the rule with the Medicaid State Plan, which does not have specific time limitations on inpatient withdrawal management services.
Agency contact:
Brian Jensen, rule writer
360-725-0815
Preproposal (CR101) - WSR 21-20-034
Filed date: 09/27/2021
Payment methods - New hospitals
Affected WAC: 182-550-4100
Pending formal proposal
Filed date: 07/23/2021
Description: HCA plans to amend this section to include an exception to per diem rate calculations for psychiatric per diem rates. This aligns with the agency’s State Plan.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 21-16-016
Filed date: 07/23/2021
Hospital sections
Affected WAC: 182-550-3800, 182-550-3830, 182-550-7500
Pending formal proposal
Filed: 7/14/2021
Description: The Health Care Authority (HCA) is amending these sections to add qualifying criteria for and reflect an extension of the current rate increase for Sole Community hospitals. ESSB 5092, Sec. 211, (46) extends the rate increase through June of 2023. HCA also plans to implement ESSB 5092, Sec. 215 (66) to adjust rates paid for long-term civil commitments. Hospitals may now submit costs not included in their Medicare cost report to be evaluated by the agency for a potential rate increase.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 21-15-041
Filed: 7/14/2021
Hospital payment methods - State-administered programs
Affected WAC: 182-550-4800
Accepting comments
Hearing date: 10/26/2021
Description: The agency is amending these rules to update the grouper from AP DRG to APR DRG and remove references to version 23.
Agency contact:
Valerie Freudenstein, rule writer
360-725-1344
Preproposal (CR101) - WSR 21-15-015
Filed: 7/8/2021
Proposal (CR102) - WSR 21-19-105
Hearing date: 10/26/2021
*Comments due 10/26/2021
Administrative day rate and swing bed day rate
Affected WAC: 182-550-4550
Pending formal proposal
Filed date: 06/11/2021
Description: The agency is amending WAC 182-550-4550 to provide hospitals an administrative day rate for days in which a postpartum client does not meet criteria for acute inpatient level of care but their infant is still an inpatient being observed for potential neonatal abstinence/opioid withdrawal syndrome and the primary and appropriate first line treatment for the infant is continuous care by the parent.
Agency contact:
Brian Jensen, rule writer
360-725-0815
Preproposal (CR101) - WSR 21-13-051
Filed date: 06/11/2021