DSHS and HCA forms, WACs, rule-making, and useful LTC links
Revised date
HCA and DSHS forms
HCA and DSHS WACs and rulemaking links
- Title 388 of Washington Administrative Code (WAC) Department of Social & Health Services (DSHS) Code reviser site
- Title 182 of Washington Administrative Code (WAC) Health Care Authority (HCA) Code reviser site
- Health Care Authority (HCA) WAC rules index
- DSHS Rules and Policies Assistance Unit (Title 388)
- Health Care Authority (HCA) recent Medicaid rule filings. (Title 182)
Aging and long-term supports intake phone numbers and links
- Aging and Long-Term Supports Administration
- Home and Community Services (HCS) APS, Area Agencies on Aging (AAA) caregiver and provider resources, locate by county
- Residential Care Services (RCS) nursing home or assisted living complaints. 800-562-6078 or cru@dshs.wa.gov
- Residential Care Services (RCS) Information on adult family home, assisted living and nursing home providers
- Intake phone numbers for Home and Community Services (request for HCS services; in-home care, care in a residential setting or nursing facility coverage) are found in Applications for long term services and supports (LTSS).
For more information on who does what LTSS program, see Overview- Long-term Services and Supports chart.
CSD/ESA contact numbers
- Community Service Division
- CSD Statewide Call Center 877-501-2233
- CSD specialty Provider Line (spend down) 800-394-4571
- CSD Fax line for clients and stakeholders 888-338-7410
Health Care Authority (HCA) links frequently used by LTSS staff
Health Care Authority (HCA) Health Care Coverage - Washington Apple Health (WAH) /information links
- Health Care Authority (HCA) internet (Main Medicaid Agency)
- Washington Health Benefit Exchange effective 10/1/2013 individuals can apply for health care coverage through the Health Plan Finder
- Eligibility for Medical Programs (internet HCA description of medical programs including medical standards)
HCA - medical assistance coverage
- Scope of care
- Medical Assistance Eligibility Overview (booklet)
- Medication Coverage Lists including over the counter items
- Pharmacy Information
- Wheelchairs, DME and supplies
- Transportation Services
- Prosthetic and Orthotic Devices
- Home infusion services
HCA - medical assistance administrative hearing rules
Managed care, TPL and long-term care insurance information
HCA NF billing guides
- Health Care Authority Nursing Facility Provider Billing Guide
- ProviderOne Billing and Resource Guide (includes provider notices)
HCA help desk and online services
- Washington State Medicaid Customer Service (toll-free number and email link for customers and providers, use this link to order a replacement medical service card)
- Washington State Medicaid P1 find a provider
HCA smarter track mailbox for internal ProviderOne manual updates
When to use mmishelp@hca.wa.gov: Situation: Client gets discharged from a NF and cannot get a prescription filled because of the coding. We need to email mmishelp@hca.wa.gov when needing a manual fix in the system. This includes when we correct an incorrect date of death in ACES. Once the case is closed in ACES, any fix must be manually sent over to HCA to match ACES data.
HCA Medicare buy-in issues:
- Field staff use Barcode tickler 102@MBU
- For clients, contact the Medicaid Customer Service Center 800-562-3022
Federal Medicaid, Medicare, Social Security and Railroad Retirement links used in LTC
- Centers for Medicare & Medicaid Services (CMS) -Health & Human Services portal to Medicare and Medicaid information
- Medicaid.gov
- Spousal Impoverishment including standards and post eligibility from Medicaid.Gov
- Third Party Liability and Coordination of Benefits from Medicaid.Gov
- SSA's Program Operations Manual System (POMS) (Federal site for policy on SSI related programs
- Railroad Retirement 877-772-5772
- Social Security Act
- Social Security Online
- Code of Federal Regulations (CFR)
- Medicare - Official U.S. Government Site for Medicare
Useful links used in LTC. Washington LawHelp, Ombudsman, RCS complaint line, SHIBA
- Long-term care assistance (Estate Recovery, COPES, in-home care, Nursing Facility medicaid overview from Washington LawHelp
- Effect of marital separation on Medicaid eligibility from Washington LawHelp
- LTC Ombudsman Program 800-562-6028
- Statewide Health Insurance Benefits Advisors (SHIBA) Helpline (assistance with Medical insurance including Medicare D plans)