Apple Health (Medicaid) rulemaking

The agency is amending these rules to remove food assistance from the calculation of income when determining a person’s eligibility for Washington Apple Health Supplemental Security Income (SSI)-related medical programs. These amendments are consistent with changes to federal rules regarding the treatment of food assistance within the SSI program, effective September 30, 2024.

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 182-517-0100 to increase the eligibility threshold for certain medicare savings programs.

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.

The agency is adding the 1915i income disregard equal to the difference between 150% of the Federal Poverty
Level and 300% of the Federal Benefit Rate. This disregard is targeted to individuals seeking Community Behavioral Health
Support Services (CBHS). This rulemaking aligns with the establishment of the CBHS program, filed under WSR 24-10-081,
effective July 1, 2024.l

Chapter 182-561 WAC is a new chapter to establish the Community Behavioral Support Services (CBHS) benefit.
The CBHS benefit assists eligible clients with obtaining the skills necessary to reside successfully in home and community-based
settings. The chapter includes the eligibility criteria for clients; Apple Health rules requiring medical necessity do not
apply to this benefit. The chapter also includes CBHS provider requirements, eligible diagnoses, covered services, and the
appeal process. Additionally, the agency is amending WAC 182-501-0065 to include CBHS as a service category.

The agency is amending these rules to add dental therapists as an eligible provider type.