Apple Health (Medicaid) rulemaking

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

Oral Health Connections Pilot Program
Affected WAC: 182-535-1270
Description: This rulemaking is necessary to implement Substitute Senate Bill 5883 which directs the agency to develop and implement a three-year pilot program to test the effect that enhanced dental benefits for adult Medicaid clients with diabetes and pregnant Medicaid clients have on access to dental care, health outcomes, and medical care costs. The pilot program must include enhanced reimbursement rates for specific current dental terminology codes for participating providers and an increase in the allowable number of periodontal treatments to up to four per calendar year
Agency contact:
Amy Emerson, rule writer
360-725-1348
Preproposal (CR101) - WSR 18-03-132
Filed: 1/22/18
Proposal (CR102) - WSR 18-20-118
Hearing date: 11/6/18
Permanent Adoption (CR103P) - WSR 18-24-077
Effective: 1/1/19
Infant Case Management
Affected WAC: 182-533-0370, 182-533-0390
Description: The agency is revising WAC 182-533-0370 to allow an infant’s parent who becomes pregnant during the infant’s ICM eligibility period to receive Maternity Support Services (MSS) and WAC 182-533-0390 to reduce the minimum hours of childbirth education (CBE) instruction required from eight to six.
Agency contact:
Vance Taylor, rule writer
360-725-1344
Preproposal (CR101) - WSR 18-17-004
Filed: 8/1/18
Proposal (CR102) - WSR 19-03-051
Hearing date: 2/26/19
*Comments due by COB
Permanent Adoption (CR103P) - WSR 19-06-026
Date filed: 2/28/19
Family Planning-TAKE Charge programs
Affected WAC: 182-532-001, 182-532-050, 182-532-100, 182-532-110, 182-532-500, 182-532-510, 182-532-520, 182-532-530, 182-532-533, 182-532-540, 182-532-550, 182-532-700, 182-532-720, 182-532-730, 182-532-740, 182-532-743, 182-532-745, 182-532-750, 182-532-760, 182-532-780, 182-532-790
Description: The agency is modifying the Family Planning Only Program and Take Charge Program sections to: (1) meet clinical standards, (2) align with current eligibility and provider enrollment policies, and (3) assure compliance with the recently approved federal extension of the Washington Family Planning Only Program (Demonstration Project) granted under the authority of section 1115(a) of the Social Security Act.
Agency contact:
Jason Crabbe, rule writer
360-725-9563
Preproposal (CR101) - WSR 18-12-031
Filed: 5/29/18
Proposal (CR102) - WSR 19-14-062
Hearing date: 8/6/19
Note: The agency combined Preproposal (CR101) filed under WSR 18-12-031 on 05/29/2018 and Preproposal (CR101) filed under WSR 18-12-030 on 05/29/2019 and has filed one Proposal (CR102) under WSR 19-14-062 for both projects.
Permanent Adoption (CR103P) - WSR 19-18-024
Effective: 10/1/19
Reproductive Health Services
Affected WAC: 182-532-001, 182-532--050, 182-532-100, 182-532-110, 182-532-120, 182-532-123, 182-532-125, 182-532-130, 182-532-500, 182-532-510, 182-532-520, 182-532-530, 182-532-550, 182-532-560, 182-532-570
Description: The agency is modifying the Reproductive health sections to meet clinical standards and align with current eligibility and provider enrollment policies.
Agency contact:
Jason Crabbe, rule writer
360-725-9563
Preproposal (CR101) - WSR 18-12-030
Filed: 5/29/18
Proposal (CR102) - WSR 19-14-062
Hearing date: 8/6/19
Note: The agency combined Preproposal (CR101) filed under WSR 18-12-031 on 05/29/2018 and Preproposal (CR101) filed under WSR 18-12-030 on 05/29/2019 and has filed one Proposal (CR102) under WSR 19-14-062 for both projects.
Permanent Adoption (CR103P) - WSR 19-18-024
Effective: 10/1/19
Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs)
Affected WAC: Chapter 182-548, Chapter 182-549
Description: The agency is amending these sections to clarify payment methodology and update policy for Rural Health Clinics. 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 19-14-017
Filed: 6/24/19
FQHC and RHC - Payment Methodology (Dental to MCO)
Affected WAC: Chapter 182-548, Chapter 182-549
Description: The agency is revising chapters 182-548 and 182-549 to reflect the changes being made to chapters 182-535 and 182-535A to comply with legislation in SSB 5883, Sec. 213(1)(c) regarding dental managed care plans.
Agency contact:
Michael Williams, rule writer
360-725-1346
Preproposal (CR101) - WSR 18-12-099
Filed: 6/2/18
Withdrawal (CR101) - WSR 19-12-106
Concurrent care for hospice clients age twenty and younger
Affected WAC: 182-551-1860
Description: The agency is amending WAC 182-551-1860, Concurrent care for hospice clients age twenty and younger, to remove language related to exception to rule and allow for medical necessity review of noncovered services. These changes comply with early and periodic screening, diagnostic and treatment (EPSDT) program rules under 42 CFR, Sec. 441, Subpart B, and WAC 182-534-0100, EPSDT.
Agency contact:
Vance Taylor, rule writer
360-725-1344
Preproposal (CR101) - WSR 18-15-031
Filed: 7/11/18
Proposal (CR102) - WSR 18-20-125
Hearing date: 11/6/18
Permanent Adoption (CR103P) - WSR 18-24-008
Effective: 1/1/19
Adult palliative care
Affected WAC: 182-551-1010, 182-551-1510, 182-551-1800, 182-551-1810, 182-551-1820, 182-551-1830, 182-551-1840, 182-551-1850
Description: The agency is amending these rules to add palliative services for adults.
Agency contact:
Melinda Froud, rule writer
360-725-1408
Preproposal (CR101) - WSR 18-09-073
Filed: 4/17/18
Withdrawal (CR101) - WSR 18-21-071
Effective: 10/11/18
Home Health Services
Affected WAC: 182-551-2000, 182-551-2010, 182-551-2020, 182-551-2030, 182-551-2040, 182-551-2100, 182-551-2110, 182-551-2120, 182-551-2122, 182-551-2125, 182-551-2130, 182-551-2140, 182-551-2200, 182-551-2210, 182-551-2220
Description: The agency is amending these rules as a result of federal regulations published in February 2016 under 42 C.F.R. 440, requiring that physicians document the occurrence of a face-to-face encounter (including through the use of telemedicine) within reasonable timeframes when ordering home health services for Medicaid eligible clients. The federal regulations also clarify that home health services are not restricted to clients who are homebound or to services furnished solely in the home. During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy. The agency previously filed a Preproposal Statement of Inquiry to begin rulemaking on these sections in 2016 under WSR 16-11-094. The agency withdrew the previously filed Preproposal Statement of Inquiry under WSR 18-05-031 and is rewriting the proposed rules.
Agency contact:
Melinda Froud, rule writer
360-725-1408
Preproposal (CR101) - WSR 18-05-068
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
Private Duty Nursing
Affected WAC: 182-551-3000, 182-551-3050, 182-551-3100, 182-551-3200, 182-551-3300, 182-551-3400
Description: The agency is revising WAC 182-551-3000 to update the definition of private duty nursing, and to clarify eligibility, provider contract, application and EPSDT information.
Agency contact:
Katie Pounds, rule writer
360-725-1346
Preproposal (CR101) - WSR 15-24-036
Filed: 11/20/15
Withdrawal (CR101) - WSR 17-07-079
Effective: 3/17/17
Preproposal (CR101) - WSR 17-08-008
Filed: 3/24/17
Proposal (CR102) - WSR 17-17-105
Supplemental (CR102) - WSR 18-02-094
Hearing date: 2/6/18
*Comments due by COB
Permanent Adoption (CR103P) - WSR 18-15-010
Effective: 9/1/18

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