Health Care Authority Rulemaking Notice

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Health Care Authority Rulemaking Notice

You are receiving this notice because you signed up to receive alerts for any rulemaking that occurs to one or more of the following rules.

Preproposal - Notice of Intent (CR101)

Chapter 182-558 Premium Payment Program

Purpose: The agency is amending Chapter 182-558 WAC to clarify and update eligibility criteria for clients receiving premium assistance subsidies for comprehensive health insurance. (WSR 18-06-037)

Proposal - Public Hearings (CR102)

182-535-1084 Dental-related services - Covered - Restorative services

Purpose: The agency is revising WAC 182-535-1084 to (1) allow for payment of silver diamine fluoride as a topical preventative agent in lieu of the topical fluoride treatment; (2) clarify that the coverage policy for silver diamine fluoride is per tooth; and (3) clarify that silver diamine fluoride cannot be performed and billed with interim therapeutic restoration on the same tooth when arresting caries or as a preventive agent. (WSR 18-06-030)

182-550-2900 Payment limits
182-550-3000 Payment method
182-550-3840 Payment adjustment for potentially preventable readmissions

Purpose: The agency is repealing WAC 182-550-3840 and restoring previous rule language regarding 14-day readmissions to WAC 182-550-2900 and WAC 182-550-3000. The agency is making these changes because it has determined that restoring the 14-day readmission rule is the most clinically sound and cost-effective approach to managing readmissions. (WSR 18-06-036)

182-550-3830 Adjustments to inpatient rates
182-550-7300 OPPS - Payment limitations

Purpose: The agency is amending WAC 182-550-3830, Adjustments to inpatient rates, to make changes to the timing of adjusting inpatient rates. The agency is amending WAC 182-550-7300, OPPS – Payment limitations, to strike subsection (5) that limits the agency’s payment to the total billed charges.
(WSR 18-06-048)

Permanent Adoption (CR103P)

182-513-1215 Community first choice (CFC) Eligibility
182-513-1220 Community first choice (CFC) Spousal Impoverishment protections for noninstitutional Washington apple health clients

Purpose: Section 2404 of the Affordable Care Act amended section 1924 of the Social Security Act, for the five-year period beginning January 1, 2014, to require states to apply the spousal impoverishment rules to additional individuals receiving long-term services and supports under 1915(k). The agency is amending this section to end the time-limited spousal impoverishment provisions for the Community First Choice program.
(WSR 18-06-031)