Last Update: 11/22/17

Chapter 182-538A WAC

WASHINGTON APPLE HEALTH FULLY INTEGRATED MANAGED CARE (FIMC)

WAC Sections

Washington apple health fully integrated managed care.
Definitions.
Fully integrated managed care and choice.
Qualifications to become a managed care organization (MCO) in fully integrated managed care (FIMC) regional service areas.
Qualifications to become a primary care case management (PCCM) provider in fully integrated managed care (FIMC) regional service areas.
Payments to managed care organizations (MCOs) in fully integrated managed care (FIMC) regional service areas.
Payments to primary care case management (PCCM) providers in fully integrated managed care (FIMC) regional service areas.
Scope of care for fully integrated managed care (FIMC) and behavioral health services only (BHSO) enrollees.
Managed care emergency services for fully integrated managed care (FIMC) enrollees.
The grievance and appeal system, and agency administrative hearing for fully integrated managed care (FIMC) managed care organization (MCO) enrollees.
The administrative hearing process for primary care case management (PCCM) enrollees in FIMC regional service areas.
Fully integrated managed care (FIMC) enrollee request for a second medical opinion.
Exemptions and ending enrollment in fully integrated managed care (FIMC).
Fully integrated managed care (FIMC) quality of care.
Apple health foster care program in fully integrated managed care regional service areas.
Program integrity requirements.
Notice requirements.
Rights and protections.
Behavioral health services only (BHSO).
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