Apple Health (Medicaid) rulemaking

The agency is amending this rule to include criteria to allow agency-approved online classes with a one-on-one check-in with the client and qualified CBE
provider during or after the online classes have been completed by the client.

The agency is adding a new section describing system requirements for electronic visit verification (EVV) for home health care services.

The agency is reviewing these rules and may amend them as needed to comply with the CURES Act of 2016; Public Law 114-255, which implements the electronic visit verification (EVV) requirement for home health care service claims to be paid. In addition, HCA is amending Chapter 182-551 WAC to update the rules to be consistent with the other rules for administration of the medicaid program.

The agency is revising these rules to allow for reimbursements of professional services for home infusions.

The agency is amending 182-550-1900 and 182-550-2100 to update which transplant procedures are covered and where the transplants can be performed. The agency is also repealing WAC 182-550-2200 Transplant requirements – COE, as this section will no longer be necessary due to the changes being proposed to 182-550-1900 and 182-550-2100. As a result of these changes, the agency is also amending WAC 182-531-0650 and 182-531-1750.

The agency is amending 182-550-5130 to remove subsections (5) and (6). The agency does not distribute any state funded grants for IMD DSH; there is no state money allocated to IMD. The agency is repealing 182-550-5210, 182-550-5220, and 182-550-5380; old information – the programs have not been funded by the legislature for over ten years.

The agency is amending these rules to reduce the sole community hospital rate multiplier to 1.25, effective July 1, 2024.

The agency is amending these rules to provide more general language due to frequent changes of percentages and dollar amounts.

The agency is amending this rule to add gender affirming surgery services to being exempt from DRG payment.