Medicaid alternative care (MAC)—Eligibility.
(1) The person receiving care must meet the financial eligibility criteria for medicaid alternative care (MAC).
(2) To be eligible for MAC services, the person receiving care must:
(a) Be age 55 or older;
(b) Be assessed as meeting nursing facility level of care under WAC
388-106-0355, and choose to receive services under the MAC program instead of other long-term services and supports;
(d) Live at home and not in a residential or institutional setting;
(e) Have an eligible unpaid caregiver under WAC
388-106-1905;
(f) Meet citizenship and immigration status requirements under WAC
182-503-0535 (2)(a) or (b); and
(g) Be eligible for either:
(i) A noninstitutional medicaid program, which provides categorically needy (CN) or alternative benefit plan (ABP) scope of care under WAC
182-501-0060; or
(ii) An SSI-related CN program by using spousal impoverishment protections institutionalized (SIPI) spouse rules under WAC
182-513-1660.
(3) An applicant whose eligibility is limited to one or more of the following programs is not eligible for MAC:
(d) The family planning only programs under chapter
182-532 WAC;
(e) The medical care services (MCS) program under WAC
182-508-0005;
(g) The state funded long-term care for noncitizens program under WAC
182-507-0125;
(h) The kidney disease program under chapter
182-540 WAC; or
(i) The tailored supports for older adults (TSOA) program under WAC
182-513-1610.
(4) The following rules do not apply to services provided under the MAC benefit:
(c) Estate recovery under chapter
182-527 WAC.
[Statutory Authority: RCW
41.05.021 and
41.05.160. WSR 23-11-007, § 182-513-1605, filed 5/4/23, effective 6/4/23. Statutory Authority: RCW
41.05.021,
41.05.160, 2016 1st sp.s. c 36 § 213 (1)(e), section 1115 of the Social Security Act, and 42 C.F.R. §§ 431.400 through 431.428. WSR 17-12-019, § 182-513-1605, filed 5/30/17, effective 7/1/17.]