PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 01-01-006.
Title of Rule: WAC 388-545-900 Neurodevelopmental centers.
Purpose: The department is proposing rules to reflect long-standing operational policy regarding the services covered by DSHS/MAA and delivered in neurodevelopmental centers. Client eligibility, provider requirements and service limitations are being proposed in rule.
Statutory Authority for Adoption: RCW 74.09.080.
Statute Being Implemented: RCW 74.09.520 and 74.09.530.
Summary: Proposed rule describes client eligibility, provider requirements and billing limitations for neurodevelopmental centers participating in the programs of the DSHS/MAA.
Reasons Supporting Proposal: Required by chapter 34.05 RCW. Long-standing operating policy is being promulgated as required by the Administrative Procedure Act.
Name of Agency Personnel Responsible for Drafting: Mike Freeman, Regulatory Improvement Manager, P.O. Box 45533, Olympia, WA, (360) 725-1350; Implementation and Enforcement: Beverly Atteridge, RN, Program Manager, P.O. Box 45506, Olympia, WA, (360) 725-1575.
Name of Proponent: Department of Social and Health Services, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: The department is proposing rules to reflect long-standing operational policy regarding the services covered by DSHS/MAA and delivered in neurodevelopmental centers. Client eligibility, provider requirements and service limitations are being proposed in rule.
Proposal Changes the Following Existing Rules: The proposed rules promulgate long-standing operational policy. They propose a new section of rules (the change) for a program that has been in existence for several years. The need for rules to cover this program was determined as a result of the governor's regulatory improvement initiative.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rules promulgate long-standing operational policy. They add no requirements to operations and therefore they do not impose costs or have an economic impact on small businesses.
RCW 34.05.328 applies to this rule adoption. This rule meets the definition of a significant legislative rule. However, the rule imposes no additional costs to businesses or local governments. A cost benefit analysis was completed and is available upon request.
Hearing Location: Blake Office Park (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA 98503, on September 4, 2001, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Kelly Cooper, DSHS Rules Coordinator, by August 29, 2001, phone (360) 664-6094, TTY (360) 664-6178, e-mail coopeKD@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, by September 4, 2001.
Date of Intended Adoption: Not sooner than September 5, 2001.
July 27, 2001
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit
2958.2(a) Neurodevelopmental centers that may be reimbursed as such by the medical assistance administration (MAA);
(b) Clients who may receive covered services at a neurodevelopmental center; and
(c) Covered services that may be provided at and reimbursed to a neurodevelopmental center.
(2) In order to provide and be reimbursed for the services listed in subsection (4) of this section, MAA requires a neurodevelopmental center provider to do all of the following:
(a) Be contracted with the department of health (DOH) as a neurodevelopmental center;
(b) Provide documentation of the DOH contract to MAA;
(c) Sign a core provider agreement with MAA; and
(d) Receive a neurodevelopmental center provider number from MAA.
(3) Clients who are twenty years of age or younger and who meet the following eligibility criteria may receive covered services from neurodevelopmental centers:
(a) For occupational therapy, refer to WAC 388-545-300(2);
(b) For physical therapy, refer to WAC 388-545-500(2);
(c) For speech therapy and audiology services, refer to WAC 388-545-700(2); and
(d) For early and periodic screening, diagnosis and treatment (EPSDT) screening by physicians, refer to WAC 388-529-0200.
(4) MAA reimburses neurodevelopmental centers for providing the following services to clients who meet the requirements in subsection (3) of this section:
(a) Occupational therapy services as described in WAC 388-545-300;
(b) Physical therapy services as described in WAC 388-545-500;
(c) Speech therapy and audiology services as described in WAC 388-545-700; and
(d) Specific pediatric evaluations and team conferences that are:
(i) Attended by the center's medical director; and
(ii) Identified as payable in MAA's billing instructions.
(5) In order to be reimbursed, neurodevelopmental centers must meet MAA's billing requirements in WAC 388-502-0020, 388-502-0100 and 388-502-0150.
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