Apple Health (Medicaid) rulemaking

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

Rule making activities

Description
The agency is amending this rule to make language less restrictive in subsection (5)(c) from covering a “case study when done in conjunction with limited or comprehensive orthodontic treatment only” to a “case study when done in conjunction with orthodontic treatment.”

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Supplemental (CR102)

  • WSR 23-22-055
  • Hearing date and Comments due by : 12/5/2023
  • Registration required: https://us02web.zoom.us/webinar/register/WN_3tyz-7OOQNW4WTLeVvp-jA

Permanent Adoption (CR103P)

Description
The agency is amending this rule to increase the allowable number of periodontal treatments to up to four per 12-month period for Apple Health eligible clients, ages 21 and over, with a current diagnosis of diabetes. Effective January 1, 2024, periodontal maintenance is allowed once every three months when criteria is met.

Agency contacts

Rulemaking contact
Program contact

Pixie Needham

Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending these rules to (1) Correct an incorrect WAC subsection reference in 182-535-1098(4)(c). Subsection (4)(c) indicates refer to WAC 182-535-1094(3) and should be 182-535-1094(4); (2) Remove subsection (2)(f)(x), replacement of agency-purchased prosthodontics, from WAC 182-535-1100 Not covered. Dentures are a covered service.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending this rule to remove subsection (4)(e) to be less restrictive for providers using removable appliances as part of orthodontic treatment. The agency is also removing “with an alveolar process involvement” from subsection (1)(a) to eliminate limiting clients who have a cleft lip to those with an alveolar process involvement.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending this rule to expand screening and preventative services for certain sexually transmitted infections during a client visit focused on family planning.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Withdrawal (CR101)

Emergency Adoption (CR103E)

Preproposal (CR101)

Description
RCW 74.09.830 provides full-scope coverage for 12 months postpartum for pregnant or postpartum persons. This coverage is more generous than and thus replaces the limited scope “Family planning only – Pregnancy related program.” The agency intends to remove language related to this superseded program from chapter 182-532 WAC.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Description
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.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

  • WSR 23-18-078
  • Hearing Date and Comments due by: 10/10/2023
  • Registration required: https://us02web.zoom.us/webinar/register/WN_fMyM6MV1SmqpIcKuyrlgYQ

Permanent Adoption (CR103P)

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

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Description
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.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

  • WSR 23-19-051
  • Hearing Date and Comments due: 10/24/2023
  • Registration required: https://us02web.zoom.us/webinar/register/WN_FvUlfbhASZWrHPKvhuxmvA

Permanent Adoption (CR103P)

Description
The agency is amending these rules to remove the requirement to use shipping dates or receipt dates as the date of service. This change simplifies the billing process for enteral products.

Agency contacts

Rulemaking contact
Rulemaking status history

Preproposal (CR101)

Withdrawal (CR101)

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)