Apple Health (Medicaid) rulemaking

The agency is amending WAC 182-531A-0900, Applied behavior analysis (ABA) – Covered services, to specify
that the agency’s applied behavior analysis program does not pay for services provided by a client’s parent, guardian,
caregiver, or other support person.

In WAC 182-501-0070, the agency removed naturopathy from the noncovered services list.
In WAC 182-502-0002, the agency added Birth Doula as an eligible provider type. This is necessary to support a separate rulemaking filed under WSR 24-10-016, on April 19, 2024. The agency also added Behavior Health Support Specialist (BHSS) as an eligible provider type. This is necessary to support a separate rulemaking filed under WSR 24-16-024, on July 26, 2024.
As a result of a recent Office of Financial Management (OFM) directive, the Health Care Authority (HCA) is pausing implementation of coverage for adult chiropractic and acupuncture services planned for 1/1/2025.
The following proposed rule sections filed under WSR 24-19-096 will not be adopted at this time:
182-502-0003 Noneligible provider types
182-531-0150 Noncovered physician-related and health care professional services- General and administrative
182-556-0200 Chiropractic services
182-556-0250 Acupuncture services (New)

The agency is amending its rules to comply with federal regulations. Effective June 3, 2024, the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, removed a federal rule, 42 CFR § 435.608, thus eliminating the requirement to apply for other benefits as a condition of Medicaid eligibility. States were given 12 months after the effective date to comply.

The agency is amending this rule to update the list of programs for which a person cannot be concurrently eligible with the Medicaid alternative care program.

The agency is providing continuous eligibility for children ages zero to six covered through the Apple Health Children’s Health Insurance Program.

The agency is amending WAC 182-513-1380 to clarify the scope of the housing maintenance allowance.

The agency is amending WAC 182-511-1250 to add detail that will clarify how the agency determines countable income when calculating the program’s premium.

Under Washington’s Medicaid Transformation Project 2.0 in accordance with Section 1115(a) of the Social Security Act, HCA is amending these sections to provide reentry services before the beneficiary’s expected date of release.

The agency is correcting Washington Administrative Code cross citations. The proposed rule corrects typographical errors without changing the rule’s effect.

The agency is amending WAC 182-507-0130 and WAC 182-509-0001 to update the income and resource eligibility standards for the refugee medical assistance program.