PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 99-05-044.
Title of Rule:
| Title of Rule | Summary | Proposed Action |
| 388-86-022 School medical services for special education students. | Describes covered services, providers, and approved locations for services provided to eligible students. Incorporate into new WAC 388-537-0100. | Repeal |
| 388-87-020 Subrogation. | Defines subrogation as it applies to the department, eligible clients, and recovery of medical care costs from liable third parties. Incorporate into new WAC 388-501-0100. | Repeal |
| 388-87-025 Services requiring approval. | Explains that reimbursement for medical services is subject to review and approval. Incorporate into new WAC 388-501-0050. | Repeal |
| 388-87-105 Payment--Medical care outside the state of Washington. | Describes requirements for out-of-state medical care for eligible clients and providers. Incorporate into new WAC 388-557-0100. | Repeal |
| 388-87-250 Third party resources. | Describes when MAA requires a liable third party to reimburse a provider or MAA. Incorporate into new WAC 388-501-0200. | Repeal |
| 388-501-0050 Services requiring approval. | Explains that reimbursement for medical services is subject to review and approval. | New |
| 388-501-0100 Subrogation. | Defines subrogation as it applies to the department, eligible clients, and recovery of medical care costs from liable third parties. | New |
| 388-501-0175 Medical care provided in bordering cities. | Lists certain bordering cities where a Washington resident may receive services. | Amend |
| 388-501-0200 Third party resources. | Describes when MAA requires a liable third party to reimburse a provider or MAA. | New |
| 388-502-0250 Interest penalties--Providers. | Describes when interest penalties may by assessed on providers who receive excess or inappropriate payments. | Amend |
| 388-530-1800 Requirements for pharmacy. Claim payments. | Describes how pharmacies must bill for claims. | Amend |
| 388-530-2050 Out-of-state prescriptions. | Describes when MAA pays for out-of-state prescriptions. | Amend |
| 388-537-0100 School medical services for special education students. | Describes covered services, providers, and approved locations for services to eligible students. | New |
| 388-540-001 Kidney centers--Purpose. | Describes the department's purpose for this program. | Amend |
| 388-540-005 Definitions. | Defines terms used in the kidney centers chapter. | Amend |
| 388-540-010 Services. | Describes the services that must be provided in a kidney center. | Amend |
| 388-540-020 Reimbursement. | Explains the requirements that kidney centers must meet to be reimbursed for services provided to eligible clients. | Amend |
| 388-540-030 KDP Eligibility requirements. | Describes the requirements that an eligible client must meet in order to receive services at a kidney center. | Amend |
| 388-540-040 Transfer of resources without adequate consideration. | Describes what may happen if a client knowingly transfers nonexempt resources at less than fair market value in order to be eligible to receive services. | Amend |
| 388-540-050 Fiscal information. | Describes what fiscal information MAA requires from kidney centers. | Amend |
| 388-540-060 KDP Eligibility determination. | Describes eligibility requirements for kidney centers and clients of the program. | Amend |
| 388-557-0100 Payment for medical care outside the state of Washington. | Describes requirements for out-of-state medical care to eligible clients and providers. | New |
Purpose: The department is reviewing the rule for compliance with the clear writing principles in the Governor's Executive Order 97-02. The rules have been rewritten for clarity and simplification without making any policy changes. In some cases, current versions of rules are being repealed and the revised versions are being proposed as part of a new chapter. Again, there are no policy changes in the revised versions of these rules. This review is essentially a "housekeeping" action.
Statutory Authority for Adoption: RCW 74.04.050, 74.08.090.
Statute Being Implemented: RCW 74.04.050, 74.08.090.
Summary: The department has reviewed the rules in order to comply with the Governor's Executive Order 97-02. The rules have been rewritten in order to clarify and simplify the language, without making any changes to policy. Some rules are being repealed in order to consolidate those policies in proposed new chapters; the revised versions of the repealed rules do not change existing policy.
Reasons Supporting Proposal: To comply with the Governor's Executive Order 97-02.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Ann Myers, MAA Rules Coordinator, 617 8th Avenue S.E., Olympia, WA 98501, (360) 586-2337.
Name of Proponent: Department of Social and Health Services, Medical Assistance Administration, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: See Title of Rule above.
Proposal Changes the Following Existing Rules: See Title of Rule above.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has reviewed the proposed rule amendments and repeals and concludes that no new costs will be imposed on the businesses affected by them.
RCW 34.05.328 does not apply to this rule adoption. The proposed amendments do not make "significant amendments to a policy or regulatory program" since no policy changes have been made. Therefore, the department concludes that the proposed amendments are not significant legislative rules.
Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on November 23, 1999, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Paige Wall by November 12, 1999, phone (360) 664-6094, TTY (360) 664-6178, e-mail wallpg@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, Paige Wall, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, by November 23, 1999.
Date of Intended Adoption: November 24, 1999.
September 30, 1999
Marie Myerchin-Redifer, Manager
Rules and Policies Assistance Unit
Reviser's note: The material contained in this filing exceeded the page-count limitations of WAC 1-21-040 for appearance in this issue of the Register. It will appear in the 99-21 issue of the Register.