WAC 182-503-0090 Washington apple health -- Exceptions to rule.
Effective March 1, 2021.
- A client or client's representative may request an exception to a Washington apple health financial eligibility rule in Title 182 WAC. The request for an exception to rule (ETR) may be submitted orally or in writing. The request must:
- Be received within ninety calendar days of the agency action with which the client disagrees or wants waived;
- Identify the rule for which an exception is being requested;
- State what the client is requesting; and
- Describe how the request meets subsection (2) of this section.
- The agency director or designee has the discretion to grant an ETR if they determine that the client's circumstances satisfy the conditions below:
- The exception would not contradict a specific provision of federal or state law; and
- The client's situation differs from the majority; and
- It is in the interest of the overall economy and the client's welfare, and:
- It increases opportunity for the client to function effectively; or
- The client has an impairment or limitation that significantly interferes with the usual procedures required to determine eligibility and payment.
- A client does not have a right to an administrative hearing on ETR decisions under chapter 182-526 WAC.
- A client is mailed a decision in writing within ten calendar days when agency staff:
- Approve or deny an ETR request; or
- Request more information.
- If the ETR is approved, the notice includes information on what is improved and for what time frame.
- The agency designates staff at the aging and long-term support administration (ALTSA) and the developmental disabilities administration (DDA) to process all ETRs specifically relating to long-term services and supports programs described in Title 182 WAC.
- This section does not apply to requests that the agency pay for noncovered medical or dental services or related equipment. WAC 182-501-0160 applies to such requests.