Apple Health (Medicaid) rulemaking

This page includes all of the current rule making activity for Washington Apple Health (Medicaid)

Rule making activities

Description
HCA is amending this rule to clarify requirements for proof of delivery of all medical equipment and supplies.

Agency contacts

Rulemaking contact

Jason Crabbe

Program contact

Dani Crawford

Rulemaking status history

Preproposal (CR101)

Withdrawal (CR101)

Preproposal (CR101)

Description
The agency is amending WAC 182-543-3300. Rule updates will include updated medical necessity criteria based on evidence review(s).

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Dani Crawford

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending this rule to update medical equipment, supplies, & appliances definitions to align with industry standard.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Dani Crawford

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
HCA is amending these rules to change the medical necessity criteria for hospital beds and to clarify the process for submitting prior authorization requests to HCA.

Agency contacts

Rulemaking contact

Jason Crabbe

Program contact

Dani Crawford

Rulemaking status history

Preproposal (CR101)

Description
The agency amended WAC 182-543-5700 to correct the number for a form titled Medical Necessity for Wheelchair
Purchase for Nursing Facility Clients. The correct form number is HCA 19-0006.

Agency contacts

Rulemaking contact

Brian Jensen

Rulemaking status history

Expedited Adoption (CR105)

Permanent Adoption (CR103P)

Description
HCA is removing all instances of “automated maximum allowable cost” and “AMAC” from WAC 182-530-7150 and repealing WAC 182-530-8150. HCA is no longer using AMAC as a reimbursement method.

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Wendy Steffens

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
HCA is amending these rules to add clarity and provide more detail on program requirements for how fee-for-service drugs must be billed to HCA for providers that are subject to the 340B program requirements.

Agency contacts

Rulemaking contact

Jason Crabbe

Program contact

Natalia Oxford Wilson

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending WAC 182-531-1850 to allow for exceptions to the general rule that the agency does not make separate reimbursement for Centers for Medicare and Medicaid Services bundled services.

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Wendy Steffens

Rulemaking status history

Preproposal (CR101)

Description
The agency is revising this section to add behavior health support specialists as a provider part of the collaborative care team.

Agency contacts

Rulemaking contact

Valerie Freudenstein

Program contact

Brian Miller

Rulemaking status history

Preproposal (CR101)

Description
The agency is adding Independent Diagnostic Testing Facilities as a provider type.

Agency contacts

Rulemaking contact

Melinda Froud

Program contact

Andrea Allen

Rulemaking status history

Preproposal (CR101)