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)

182-546-0200 Scope of coverage for ambulance transportation
182-546-0250 Ambulance services the department does not cover
182-546-0400 General information
182-546-0500 Payment for ground ambulance services in special circumstances
182-546-0700 Payment limitations for air ambulance services

Purpose:  This rulemaking is necessary to implement E2SHB 1358 which directs the agency to adopt standards for the reimbursement of health care services provided to eligible clients by fire departments pursuant to a community assistance referral and education services program under RCW 35.21.930. The standards must allow payment for covered health care services provided to individuals whose medical needs do not require ambulance transport to an emergency department. (WSR 18-11-091)

182-543-9000 DME and related supplies, complex rehabilitation, prosthetics, orthotics, medical supplies and related services - General reimbursement 
182-543-9100 Reimbursement method - Other DME
182-543-9200 Reimbursement method - Wheelchairs
182-543-9250 Reimbursement method - Complex rehabilitation technology
182-543-9300 Reimbursement method - Prosthetics and orthotics
182-543-9400 Reimbursement method - Medical supplies and related services

Purpose: The agency intends to amend Chapter 182-543 WAC to align with section 503 of the Consolidated Appropriations Act, 2016 and section 5002 of the 21st Century Cures Act of 2016, which added section 1903(i)(27) to the Social Security Act (the Act). These changes prohibit federal Medicaid reimbursement to states for certain durable medical equipment (DME) expenditures that are, in the aggregate, in excess of what Medicare would have paid for such items. (WSR 18-11-093)

182-531-0200 Physician-related and health care professional services requiring prior authorization

Purpose: The agency is amending this WAC to remove the reference to consent forms and replace with "written acknowledgement." This amendment will align WAC 182-531-0200 with 42 CFR 441.255(c), WAC 182-531-0050, RCW 7.70.060, and RCW 7.70.065. (WSR 18-11-105

Permanent Adoption (CR103P)

182-531-1500 Sleep Studies

Purpose: The agency is amending this rule to revise the requirements for sleep center to become an agency-approved center of excellence (COE). The agency plans to reduce the number of documents that must be submitted for each sleep center. The agency will instead use the sleep center’s certification by the American Academy of Sleep Medicine (AASM), which requires the same documentation as listed in the current rule. (WSR 18-11-106)

Expedited Rulemaking (CR105)

182-531A-0800 Applied behavior analysis (ABA) - Provider Requirements

Purpose: The agency is revising this rule to correct typographical errors in two form numbers. In WAC 182-531A-0800(4), the correct form number is HCA 13-0009, not 13-009. In WAC 182-531A-0800(8)(b), the correct form number is HCA 13-0008, not 13-008.This correction is necessary so that providers can find the correct form on HCA’s Forms web page. (WSR 18-11-092)