Health Care Authority Rulemaking Notice

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Health Care Authority Rulemaking Notice

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Preproposal - Notice of Intent (CR101)

182-501-0135 Patient review and coordination (PRC)
182-502-0160 Billing a client
Purpose: The agency is amending WAC 182-501-0135, Patient review and coordination (PRC), to update policy and remove outdated information. The agency is amending WAC 182-502-0160, Billing a client, specifically subsection (6)(d), to align the language with changes being proposed to WAC 182-501-0135. (WSR 17-21-016)

Proposal - Public Hearings (CR102)

182-513-1105 - Personal needs allowance (PNA) and room and board standards in a medical institution and alternate living facility (ALF). 
182-513-1205 - Determining eligibility for noninstitutional coverage in an alternate living facility (ALF)
182-513-1215 - Community first choice (CFC)—Eligibility.
182-513-1225 -  Medicaid personal care (MPC)
182-513-1380 - Determining a person's financial participation in the cost of care for long-term care in a medical institution
182-514-0263 - Non-SSI-related institutional medically needy coverage for pregnant women and people age twenty and younger.
182-515-1507 - Home and community based (HCB) waiver services authorized by home and community services (HCS)—Financial eligibility if a person is eligible for an SSI-related noninstitutional categorically needy (CN) medicaid program.
182-515-1509 - Home and community based (HCB) waiver services authorized by home and community services (HCS)—Client financial responsibility.
182-515-1512 - Home and community based (HCB) waiver services authorized by the developmental disabilities administration (DDA)—Financial eligibility if a person is eligible for a noninstitutional SSI-related categorically needy (CN) program.
182-515-1514 - Home and community based (HCB) services authorized by the developmental disabilities administration (DDA)—Client financial responsibility.
Purpose: Senate Bill 5118 was signed into law that increases the personal needs allowance based on the Social Security cost of living adjustment. This adjustment is subject to legislative funding. The agency adjusted the PNAs accordingly and moved them into a new section, WAC 182-513-1105, to be kept together. (WSR 17-20-103)

Permanent Adoption (CR103P)

182-535-1050 Dental-related services - Definitions
182-535-1060 Dental-related services—Client eligibility.
182-535-1066 Dental-related services—Medical care services clients
182-535-1070 Dental-related services—Provider information.
182-535-1079 Dental-related services—General.
182-535-1082 Dental-related services—Covered—Preventive services.
182-535-1084 Dental-related services—Covered—Restorative services.
182-535-1086 Dental-related services—Covered—Endodontic services.
182-535-1088 Dental-related services—Covered—Periodontic services.
182-535-1090 Dental-related services—Covered—Prosthodontics (removable).
182-535-1094 Dental-related services—Covered—Oral and maxillofacial surgery services.
182-535-1098 Dental-related services—Covered—Adjunctive general services. 182-535-1099 Dental-related services for clients of the developmental disabilities administration of the department of social and health services.
182-535-1100 Dental-related services—Not covered.
182-535-1220 Obtaining prior authorization for dental-related services.
182-535-1245 Access to baby and child dentistry (ABCD) program.
182-535A-0010 Orthodontic services—Definitions.
182-535A-0020 Orthodontic treatment and orthodontic services—Client eligibility.
182-535A-0040 Orthodontic treatment and orthodontic-related services—Covered, noncovered, and limitations to coverage.
182-535A-0060 Orthodontic treatment and orthodontic-related services—Payment.
Purpose: The agency is amending several sections of Chapters 182-535 WAC, Dental-related services, and 182-535A WAC, Orthodontic services. Amendments are being made to: add, remove, or update definitions; add covered services; clarify or change coverage limits; remove or update some prior authorization requirements; and clarify processes described in WAC. The revisions also include housekeeping changes.  (WSR 17-20-097)

Emergency Adoption (CR103E)

182-516-0100 Trusts
Purpose: The WAC is being 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 is also fixing references to incorrect WAC citations in WAC 182-516-0100. (WSR  17-20-104)