Apple Health (Medicaid) rulemaking

The agency is amending this rule to include state-funded long-term care services provided in an intermediate care facility for individuals with intellectual disabilities authorized by the Washington State Department of Social and Health Services, Developmental Disabilities Administration.

The agency is amending this rule to update a statutory citation.

The agency is amending
this rule to comply with statutory program requirements in RCW 74.09.340.

The agency is amending WAC 182-508-0001 and 182-512-0920 to remove the maximum age restriction for apple health for workers with disabilities (HWD) categorically needy (CN) coverage. This change is consistent with amendments made to RCW 74.09.540 and WAC 182-511-1050 effective January 1, 2020.

The agency is amending WAC 182-513-1110 on an emergency basis to remove presumptive eligibility for longterm
services and supports in an alternate living facility.

The agency is amending WAC 182-513-1100 to define Intensive Behavioral Health Treatment Facility (IBHTF) as a residential treatment facility licensed under chapter 246-337 WAC, and add additional definitions related to long-term services and supports.

The agency is amending WAC 182-509-0220 to specify that Medicare savings programs do not have a resource limit, which is consistent with section 211(40), chapter 475, Laws of 2023 and WAC 182-517-0100 as amended under WSR 22-21-043. The agency is amending WAC 182-519-0050 to correct a website address for the Washington apple health income and resource standards chart and update the medically needy income level and federal benefit rate.

The agency is amending WAC 182-517-0100 to increase the eligibility threshold for certain medicare savings programs.

The agency is amending rules to provide continuous enrollment in Medicaid through age five for children with household income below 215 percent of the federal poverty level at the time of application. This project and Apple Health renewals are being combined at the CR-102 stage because they both amend 182-504-0035.

The agency is developing rules under ESSB 5187 Sec. 211 (83), 68th Legislature, 2023 Regular Session. This legislation directs the agency to implement a program with coverage comparable the categorically needy Medicaid program for certain adults age 19 and older who: (a) have an immigration status making them ineligible for Medicaid or federal subsidies through the Health Benefit Exchange; and (b) are not eligible for another full scope federally funded medical assistance program.