WSR 17-01-037 EMERGENCY RULES HEALTH CARE AUTHORITY (Washington Apple Health) [Filed December 13, 2016, 10:06 a.m., effective December 13, 2016, 10:06 a.m.] Effective Date of Rule: Immediately upon filing.
Purpose: The agency is amending this rule to clarify that adoption support and foster care alumni can opt out of the apple health foster care program for any reason.
Citation of Existing Rules Affected by this Order: Amending WAC 182-538-150 Apple health foster care program.
Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.
Reasons for this Finding: WAC 182-538-150 (3)(b) incorrectly cites to WAC 182-538-130. The rule must clarify that adoption support and foster care alumni can opt out of the apple health foster care program for any reason. The permanent rules were filed on November 4, 2016, under WSR 16-23-021 and are effective on January 1, 2017. This emergency filing is necessary to continue the current emergency rules until the permanent rules become effective.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: December 13, 2016.
Wendy Barcus
Rules Coordinator
AMENDATORY SECTION (Amending WSR 15-24-098, filed 12/1/15, effective 1/1/16)
WAC 182-538-150 Apple health foster care program.
(1) Unless otherwise stated in this section, all of the provisions of chapter 182-538 WAC apply to apple health foster care (AHFC).
(2) The following sections of chapter 182-538 WAC do not apply to AHFC:
(a) WAC 182-538-068;
(b) WAC 182-538-071;
(c) WAC 182-538-096; and
(d) WAC 182-538-111.
(3) Enrollment in AHFC is voluntary for eligible individuals. The agency will enroll eligible individuals in the single MCO that serves children and youth in foster care and adoption support, and young adult alumni of the foster care system.
(a) The agency will not enroll a client in AHFC or will end an enrollee's enrollment in AHFC when the client has, or becomes eligible for, TRICARE or any other third-party health care coverage that would:
(i) Require the agency to either exempt the client from enrollment in managed care; or
(ii) End the enrollee's enrollment in managed care.
(b) An AHFC enrollee may request exemption from enrollment or termination of enrollment in AHFC without cause if the client is in the adoption support or young adult alumni programs ((under)). WAC 182-538-130 does not apply to these requests.
(4) In addition to the scope of medical care services in WAC 182-538-095, AHFC coordinates health care services for enrollees with the department of social and health services community mental health system and other health care systems as needed.
(5) The agency sends written information about covered services when the individual becomes eligible to enroll in AHFC and at any time there is a change in covered services. In addition, the agency requires MCOs to provide new enrollees with written information about:
(a) Covered services;
(b) The right to grievances and appeals through the MCO; and
(c) Hearings through the agency.
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