WSR 12-05-022

PREPROPOSAL STATEMENT OF INQUIRY

HEALTH CARE AUTHORITY


(Medicaid Program)

[ Filed February 7, 2012, 11:43 a.m. ]

Subject of Possible Rule Making: WAC 182-502-0010 When the department enrolls, 182-543-2000 DME and related supplies, prosthetics, orthotics, medical supplies and related services -- Eligible providers and provider requirements, and possible other related WAC sections.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 41.05.021, Affordable Care Act (ACA) - 76 Fed. Reg. 5862, 42 C.F.R. Parts 405, 424, 447, 455, 457, and 498.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: In accordance with the ACA, these rule revisions are necessary to meet the screening requirements in the ACA for high-risk categorized provider types. These rule revisions require providers of durable medical equipment (DME), prosthetics, orthotics, supplies, and related services (DMEPOS) to be medicare-enrolled providers in order to also receive payment under Washington state's medicaid program. This rule applies to newly enrolled DMEPOS providers and current DMEPOS providers upon revalidation of their enrollment (as required in C.F.R. 455.414). This requirement avoids a costly additional state screening requirement for DMEPOS providers, most of whom are already enrolled providers with medicare.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: Centers for Medicare and Medicaid Services (CMS).

Process for Developing New Rule: HCA welcomes the public to take part in developing the rules. Anyone interested should contact the staff person identified below. At a later date, HCA will file a notice of proposed rule-making (CR-102) with the office of the code reviser. A copy of the proposal will be sent to everyone on the mailing list and to anyone who requests a copy.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Wendy L. Boedigheimer, P.O. Box 45504, Olympia, WA 98504-5504, fax (360) 586-9727, TTY 1-800-848-5429, e-mail wendy.boedigheimer@hca.wa.gov.

February 7, 2012

Kevin M. Sullivan

Rules Coordinator

Washington State Code Reviser's Office