WAC 182-549-1200:

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PDFWAC 182-549-1200

Rural health clinics—Enrollment.

(1) To participate in the Title XIX (medicaid) program or the Title XXI (CHIP) program and receive payment for services, a rural health clinic (RHC) must:

(a) Receive RHC certification for participation in the Title XVIII (medicare) program according to 42 C.F.R. 491;

(b) Sign a core provider agreement with the medicaid agency;

(c) Comply with the clinical laboratory improvement amendments (CLIA) of 1988 testing for all laboratory sites per 42 C.F.R. Part 493; and

(d) Operate in accordance with applicable federal, state, and local laws.

(2) An RHC may be a permanent or mobile unit. If an entity owns clinics in multiple locations, each individual site must be certified by the agency in order to receive reimbursement from the agency as an RHC.

(3) The agency uses one of two timeliness standards for determining the effective date of a medicaid-certified RHC.

(a) The agency uses medicare's effective date if the RHC returns a properly completed core provider agreement and a properly completed RHC enrollment packet within 60 calendar days from the date of CMS's written notification to the RHC of the medicare certification.

(b) The agency uses the date the medicare certification letter is received by the agency if the RHC returns either the properly completed core provider agreement or properly completed RHC enrollment packet after 60 calendar days of the date of medicare's letter notifying the clinic of the medicare certification.

[Statutory Authority: 42 U.S.C. 1396a(bb), 42 U.S.C. 1396d (2)(A), RCW 41.05.021, and 41.05.160. WSR 22-22-049, § 182-549-1200, filed 10/27/22, effective 1/1/23. Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 20-02-070, § 182-549-1200, filed 12/26/19, effective 1/26/20; WSR 15-11-008, § 182-549-1200, filed 5/7/15, effective 6/7/15. WSR 11-14-075, recodified as § 182-549-1200, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.510, 74.09.522, 42 C.F.R. 405.2472, 42 C.F.R. 491. WSR 08-05-011, § 388-549-1200, filed 2/7/08, effective 3/9/08.]