Apple Health (Medicaid) rulemaking
This page includes all of the current rule making activity for Washington Apple Health (Medicaid)
Affected WAC: 182-552-1000
Description: The agency is revising this section to (1) clarify the clinical criteria for the rental of a backup ventilator; (2) revise the authorization requirements for ventilators; and (3) remove the outdated clinical criteria for ventilators for clients 17 years of age and younger.
Outpatient Nutritional counseling (new rules for Medical Nutrition Therapy)
Affected WAC: 182-550-6300
Description: The agency is striking the outdated language in WAC 182-550-6300 and creating a new Chapter 182-555 WAC to establish updated rules for the coverage and payment of Medical Nutrition Therapy.
Transportation - Treat and Refer (No Transport)
Affected WAC: 182-546-0200, 182-546-0250, 182-546-0400, 182-546-0500, 182-546-0700
Description: This rulemaking is necessary to implement E2SHB 1358 which directs the agency to adopt standards for the reimbursement of health care services provided to eligible clients by fire departments pursuant to a community assistance referral and education services program under RCW 35.21.930. The standards must allow payment for covered health care services provided to individuals whose medical needs do not require ambulance transport to an emergency department.
Ambulance Transportation - Eligibility, General Requirements (MCO Carve-Out)
Affected WAC: 182-546-0150, 182-546-0400
Description: Effective January 1, 2018, the agency will cover all emergency and nonemergency ambulance services provided to Apple Health clients through fee-for-service, including those transports for clients enrolled in an agency-contracted managed care organization. The agency is removing references to managed care from appropriate sections of Chapter 182-546 WAC.
Preproposal (CR101) - WSR 18-01-028
Emergency Adoption (CR103E) - WSR 18-02-023
Effective: 12/21/17 - 4/18/18
Proposal (CR102) - WSR 18-09-114
Hearing date: 5/22/18
* Comments due by COB
Emergency Adoption (CR103E) - WSR 18-10-005
Permanent Adoption (CR103P) - WSR 18-12-091
Involuntary SUD Transportation
Affected WAC: 182-546-4600
Description: The agency is creating a new section (-4600) under Chapter 182-546 WAC for ambulance transportation for involuntary substance use disorder treatment as directed by the Washington State Legislature in Engrossed Third Substitute House Bill 1713, also known as the Ricky Garcia Act.
Preproposal (CR101) - WSR 16-14-040
Emergency Adoption (CR103E) - WSR 16-14-039
Effective: 6/28/16 - 10/25/16
Emergency Adoption (CR103E) - WSR 16-22-031
Emergency Adoption (CR103E) - WSR 17-06-023
Effective: 2/22/17 - 6/21/17
Emergency Adoption (CR103E) - WSR 17-14-002
Emergency Adoption (CR103E) - WSR 17-22-007
Emergency Adoption (CR103E) - WSR 18-05-045
Proposal (CR102) - WSR 18-13-022
Hearing date: 7/25/18
*Comments due by COB
Emergency Adoption (CR103E) - WSR 18-13-050
Emergency Adoption (CR103E) - WSR 18-21-043
Effective: 10/08/18 - 2/5/19
Permanent Adoption (CR103P) - WSR 18-21-042
Affected WAC: 182-546-0001, 182-546-0100, 182-546-0200, 182-546-0250, 182-546-0300, 182-546-0400, 182-546-0425, 182-546-0450, 182-546-0500, 182-546-0600, 182-546-0700, 182-546-0800, 182-546-0900, 182-546-1000, 182-546-1500, 182-546-2500, 182-546-4000
Description: Establishing and revising rules not currently addressed or sufficiently explained in Chapter 182-546 WAC regarding emergency medical transportation; updating rule citations and other housekeeping fixes.
Ambulance Transportation (GEMT)
Affected WAC: 182-546-0505, 182-546-0510, 182-546-0515, 182-546-0520, 182-546-0525, 182-546-0530, 182-546-0535, 182-546-0540, 182-546-0545
Description: This rule making is necessary to implement House Bill 2007 which directs the agency to design and implement a supplemental medicaid reimbursement in addition to the rate of payment that an eligible provider would otherwise receive for medicaid ground emergency medical transportation services for both Fee-For-Service (FFS) and Managed Care enrolled clients. An eligible provider is one who provides ground emergency medical transportation services to medicaid beneficiaries, is enrolled as a medicaid provider, and is owned or operated by the state, a city, county fire protection district, community services district, health care district, federally recognized Indian tribe or any unit of government as defined in 42 C.F.R. Sec. 433.50.
Affected WAC: Chapter 182-502A
Description: The agency is amending this chapter to clarify and revise language to align with federal and state regulations.
School Based Health Care Services (SBHS)
Affected WAC: 182-500-0020, 182-500-0030, 182-537-0100, 182-537-0200, 182-537-0300, 182-537-0350, 182-537-0400, 182-537-0500, 182-537-0600, 182-537-0700, 182-537-0800
Description: The agency is revising this chapter to clarify eligibility, coverage and provider requirements for school based health services.
Foundational Community Supports
Affected WAC: 182-559-100, 182-559-150, 182-559-200, 182-559-300, 182-559-350, 182-559-400, 182-559-600
Description: The agency is amending chapter 182-559 WAC, Foundational community supports, to align with changes to the Foundational Community Supports program protocol that was recently approved by the Centers for Medicare & Medicaid Services (CMS). The agency is adding new WAC sections to provide more detailed information as required by the protocol. The agency is adding a new WAC section to clarify the grievance and appeals process for clients receiving services through the Foundational Community Supports program. During the course of this review, the agency may identify additional related changes that are required in order to improve clarity or update policy.
Emergency Adoption (CR103E) - WSR 18-01-146
Effective: 12/20/17- 12/28/17
Preproposal (CR101) - WSR 18-01-133
Emergency Adoption (CR103E) - WSR 18-02-064
Emergency Adoption (CR103E) - WSR 18-03-056
Emergency Adoption (CR103E) - WSR 18-11-036
5/8/18 - 9/5/18
Proposal (CR102) - WSR 18-11-109
Hearing date: 6/26/18
*Comments due by COB
Permanent Adoption (CR103P) - WSR 18-15-007