Apple Health Rule Making Notification

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Apple Health (Medicaid): Provider Alert

Preproposal - Notice of Intent (CR101)

182-526-0070 Filing documents, 182-526-0155 Appellants representation in the hearing,
182-526-0200 Enrollee appeals of a managed care organization action,  (WSR 17-12-091)
Purpose: (1) In WAC 182-526-0155, the agency inadvertently left out language that had been in the rule to comply with federal HIPAA laws that anyone requesting confidential information needs to sign an authorization for release of information; (2) in WAC 182-526-0200, the agency needed to delete subsection (8) through (10) as those subsections are now going in WAC 182-538-0110 and if left in this current rule, would conflict; and (3) in WAC 182-526-0070, the agency inadvertently wrote the rule such that it would require the actual judge to confirm documents were filed rather than support staff, creating a burden.

Proposal - Public Hearings (CR102)

182-543-2000 DME, CRT, P&O, Medical Supplies - Eligible providers & provider requirements
182-543-5000, DME, CRT, P&O, Medical Supplies- Covered- Prosthetics/orthotics, (WSR 17-12-107)
Purpose: The agency is amending these rules to add occupational therapists to the list of eligible prosthetic and orthotic providers. The agency previously filed these amendments, along with amendments to WAC 182-543-0500 and WAC 182-545-200, to comply with federal rules under 42 CFR Part 440 that establish who can prescribe medical supplies and equipment. The agency filed the previous amendments under WSR 16-19-032 and held a hearing on October 25, 2016. However, the amendments based on the federal rules have been delayed. A second public hearing is required to move forward with the sections of these rules that add occupational therapists as eligible prosthetic and orthotics providers. The agency will hold another public hearing on amendments to comply with the federal rules at a later date.

Emergency Adoption (CR103E)

182-516-0100, 21st Century Cures Act, (WSR 17-12-108)
Purpose: The WAC needs to be amended to implement Title V, Sec. 5007 the 21st Century Cures Act to allow for a person to create his or her own D4A special needs trust. The agency also needs to revise references to incorrect WAC citations in WAC 182-516-0100.