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Preproposal - Notice of Intent (CR101)
182-526-0100, -0280, -0290, Administrative hearings- new section for expedited hearings, housekeeping change, and correction, (WSR 17-08-089) Purpose: To comply with new federal rules in 42 CFR Part 431, the agency is creating a new section WAC 182-526-0100 to allow for expedited administrative hearings for urgent health care needs. The agency is revising WAC 182-526-0290(4) and (6) to correct an error in the recently filed permanent rules for Chapter 182-526 WAC. In subsection (4), if an appellant fails to appear at the scheduled prehearing conference to address the petition to vacate, the order becomes a final order. The ALJ or review judge does not dismiss the matter with prejudice. In subsection (6), if the petition to vacate is not filed timely or the appellant fails to establish good cause to excuse any default or to reinstate the matter for hearing, the ALJ must issue an initial order, not a final order, dismissing the appeal. In WAC 182-526-0280, the agency is proposing to strike the introductory statement “This section applies to continuance requests made by applicants or recipients.”
Proposal - Public Hearings (CR102)
182-500-0070; 182-559-100, -150, -200, -300, -400, -500, Foundational community supports program
(WSR 17-08-078) Purpose: The agency drafted these rules to implement a newly funded Foundational Community Supports Program that includes benefits to clients for supportive housing and supported employment services. The agency added a definition for "Medicaid transformation waiver" to WAC 182-500-0070.
182-560-100, Achieving a Better Life Experience (ABLE) Act, (WSR 17-08-086)
Purpose: The agency is creating this new section to implement the Achieving a Better Life Experience (ABLE) Act. An ABLE account allows clients who are blind or have a disability to save funds in tax-advantaged accounts for their disability-related expenses. This section clarifies how ABLE accounts are counted when determining eligibility and which funds held in an ABLE account are subject to estate recovery.
182-538-040, -050, -110, -140; 182-538B-110; 182-538C-040, -110, Managed Care Organizations Grievance and Appeals (WSR 17-08-092) Purpose: The agency is amending these rules to comply with the federal rule changes adopted by the Centers for Medicare and Medicaid Services (CMS), which revised 42 CFR Parts 431, 433, 438, 440, 457 and 495. These changes modernize the Medicaid managed care regulations to reflect changes in the use of managed care delivery systems and are primarily related to the grievance and appeals process rules.
182-505-0100, -0210, -0215, -0225, -0235, -0237, -0240, -0300, Family, Children, Pregnancy and Adult Medical Programs, (WSR 17-08-093) Purpose: The agency is updating these rules to correct the Federal Poverty Level and to eliminate the contradiction between WAC 182-505-0210 and Long-Term Care rules.
182-503-0510; 182-513-1600, -1605, -1610, -1615, -1620, -1625, -1630, -1635, -1640, -1645, -1650, -1655, -1660; 182-527-2734, -2742, Medicaid Alternative Care (MAC) and Tailored Supports for Adults (TSOA)
(WSR 17-08-095) Purpose: The agency drafted these rules to implement newly funded programs, Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA), that provide benefits for person-centered long-term services and supports (LTSS) to unpaid family members caring for Medicaid-eligible clients. The agency amended WAC 182-503-0510, Washington apple health – Program summary, to include TSOA as a program not based on modified adjusted gross income, social security income, or temporary assistance for needy families methodologies. Other changes to WAC 182-503-0510 were housekeeping changes. The agency amended WAC 182-527-2734, Liens during a client’s lifetime, to clarify when a client is not expected to return home in terms of when the agency can file a lien, and to exclude the Medicaid transformation project services when determining the amount of liens.
Permanent Adoption (CR103P)
182-531-0050, -0550, Experimental and Investigational Services (WSR 17-09-002)
Purpose: Revisions to WAC 182-531-0050 include removing the definition of “ADSA,” clarifying the definitions of “experimental” and “investigational,” and aligning the definitions of “peer reviewed medical literature” with other agency rules. Revisions to WAC 182-531-0550 include striking redundant subsections and referring to WAC 182-501-0165 as the authority for authorizing experimental or investigational services. Revisions to these WACs also include housekeeping changes.
Emergency Adoption (CR103E)
182-526-0100, Expedited administrative hearings for urgent health care needs, (WSR 17-08-087)
Purpose: As required by new Federal rules, the agency is creating a new section under Chapter 182-526 WAC, Administrative Hearings, to allow for expedited administrative hearings for urgent health care needs.
182-526-0290, Reinstating a hearing after an order of default or an order of dismissal, (WSR 17-08-088)
Purpose: The agency recently filed the permanent rules for Chapter 182-526 under WSR 17-05-066, filed February 13, 2017.This emergency rule corrects an error in subsection (4) and (6) of WAC 182-526-0290. In subsection (4), if an appellant fails to appear at the scheduled prehearing conference to address the petition to vacate, the order becomes a final order. The ALJ or review judge does not dismiss the matter with prejudice. In subsection (6), if the petition to vacate is not filed timely or the appellant fails to establish good cause to excuse any default or to reinstate the matter for hearing, the ALJ must issue an initial order, not a final order, dismissing the appeal.
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