Subject of Possible Rule Making: WAC 388-538-067 Healthy Options provider information, 388-538-068 Healthy Options primary care case management, and possible other sections in chapter 388-538 WAC, Managed care.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 74.08.090, 74.09.510, and [74.09.]522, 1115 Fed Waiver; 42 U.S.C. 1396.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The department is modifying several aspects of its managed care program, which includes Healthy Options. It is changing from a competitive procurement process to one that allows any qualified managed care organization to contract for Healthy Options; these requirements must be codified. It is also adding a primary care case management (PCCM) program as a choice to deliver mandatory managed care services to Healthy Options eligible clients. The PCCM program and the qualifications for participation in the program must be codified. It is possible that the department will find that other aspects of the Healthy Options program are affected as these rules are developed; notice is given that other rules may need to be amended to accommodate these changes.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.

Process for Developing New Rule: The department invites the interested public to review and provide input on the draft language of the proposed WAC. Draft material and information about how to participate is available from the DSHS representative below.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Ann Myers, Regulatory Improvement, P.O. Box 45533, Olympia, WA 98504, phone (360) 725-1345, e-mail myersea@dshs.wa.gov, fax (360) 586-9727.

April 24, 2001

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

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