WSR 19-17-083
PROPOSED RULES
HEALTH CARE AUTHORITY
[Filed August 21, 2019, 9:29 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 19-13-056.
Title of Rule and Other Identifying Information: WAC 182-502-0002 Eligible provider types.
Hearing Location(s): On September 24, 2019, at 10:00 a.m., at the Health Care Authority (HCA), Cherry Street Plaza, Sue Crystal Conference Room 106A, 626 8th Avenue, Olympia, WA 98504. Metered public parking is available street side around building. A map is available at https://www.hca.wa.gov/assets/program/Driving-parking-checkin-instructions.pdf or directions can be obtained by calling 360-725-1000.
Date of Intended Adoption: Not sooner than September 25, 2019.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email arc@hca.wa.gov, fax 360-586-9727, by September 24, 2019.
Assistance for Persons with Disabilities: Contact Amber Lougheed, phone 360-725-1349, fax 360-586-9727, telecommunication relay services 711, email amber.lougheed@hca.wa.gov, by September 13, 2019.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The agency is amending this section to add dental health aide therapist (DHAT) to the list of eligible providers who can be reimbursed for providing services to medicaid clients in tribal facilities.
Reasons Supporting Proposal: See purpose.
Statutory Authority for Adoption: RCW 41.05.021, 41.05.160; ESHB 1109, Section 211(49), 2019 regular session.
Statute Being Implemented: RCW 41.05.021, 41.05.160.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Michael Williams, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1346; Implementation and Enforcement: Jessie Dean, P.O. Box 45502, Olympia, WA 98504-2716 [98504-5502], 360-725-1649.
A school district fiscal impact statement is not required under RCW 28A.305.135.
A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. This rule making does not impose any additional cost or requirements on providers.
August 21, 2019
Wendy Barcus
Rules Coordinator
AMENDATORY SECTION(Amending WSR 14-06-054, filed 2/27/14, effective 3/30/14)
WAC 182-502-0002Eligible provider types.
The following health care professionals, health care entities, suppliers or contractors of service may request enrollment with the Washington state health care authority (medicaid agency) to provide covered health care services to eligible clients. For the purposes of this chapter, health care services include treatment, equipment, related supplies, and drugs.
(1) Professionals:
(a) Advanced registered nurse practitioners;
(b) Anesthesiologists;
(c) Applied behavior analysis (ABA) professionals, as provided in WAC 182-531-1410 through 182-531-1436:
(i) Certified agency-affiliated counselors;
(ii) Certified counselors; and
(iii) Certified counselor advisors.
(d) Audiologists;
(e) Chemical dependency professionals:
(i) Mental health care providers; and
(ii) Peer counselors.
(f) Chiropractors;
(g) Dentists;
(h) Dental health aide therapists, as provided in chapter 70.350 RCW;
(i) Dental hygienists;
(((i)))(j) Denturists;
(((j)))(k) Dietitians or nutritionists;
(((k)))(l) Hearing aid fitters/dispensers;
(((l)))(m) Marriage and family therapists;
(((m)))(n) Mental health counselors;
(((n)))(o) Mental health care providers;
(((o)))(p) Midwives;
(((p)))(q) Naturopathic physicians;
(((q)))(r) Nurse anesthetist;
(((r)))(s) Occularists;
(((s)))(t) Occupational therapists;
(((t)))(u) Ophthalmologists;
(((u)))(v) Opticians;
(((v)))(w) Optometrists;
(((w)))(x) Orthodontists;
(((x)))(y) Orthotist;
(((y)))(z) Osteopathic physicians;
(((z)))(aa) Osteopathic physician assistants;
(((aa)))(bb) Peer counselors;
(((bb)))(cc) Podiatric physicians;
(((cc)))(dd) Pharmacists;
(((dd)))(ee) Physicians;
(((ee)))(ff) Physician assistants;
(((ff)))(gg) Physical therapists;
(((gg)))(hh) Prosthetist;
(((hh)))(ii) Psychiatrists;
(((ii)))(jj) Psychologists;
(((jj)))(kk) Radiologists;
(((kk)))(ll) Registered nurse delegators;
(((ll)))(mm) Registered nurse first assistants;
(((mm)))(nn) Respiratory therapists;
(((nn)))(oo) Social workers; and
(((oo)))(pp) Speech/language pathologists.
(2) Agencies, centers and facilities:
(a) Adult day health centers;
(b) Ambulance services (ground and air);
(c) Ambulatory surgery centers (medicare-certified);
(d) Birthing centers (licensed by the department of health);
(e) Cardiac diagnostic centers;
(f) Case management agencies;
(g) Chemical dependency treatment facilities certified by the department of social and health services (DSHS) division of behavioral health and recovery (DBHR), and contracted through either:
(i) A county under chapter 388-810 WAC; or
(ii) DBHR to provide chemical dependency treatment services.
(h) Centers for the detoxification of acute alcohol or other drug intoxication conditions (certified by DBHR);
(i) Community AIDS services alternative agencies;
(j) Community mental health centers;
(k) Diagnostic centers;
(l) Early and periodic screening, diagnosis, and treatment (EPSDT) clinics;
(m) Family planning clinics;
(n) Federally qualified health centers (designated by the federal department of health and human services);
(o) Genetic counseling agencies;
(p) Health departments;
(q) Health maintenance organization (HMO)/managed care organization (MCO);
(r) HIV/AIDS case management;
(s) Home health agencies;
(t) Hospice agencies;
(u) Hospitals;
(v) Indian health service facilities/tribal 638 facilities;
(w) Tribal or urban Indian clinics;
(x) Inpatient psychiatric facilities;
(y) Intermediate care facilities for the mentally retarded (ICF-MR);
(z) Kidney centers;
(aa) Laboratories (CLIA certified);
(bb) Maternity support services agencies; maternity case managers; infant case management, first steps providers;
(cc) Neuromuscular and neurodevelopmental centers;
(dd) Nurse services/delegation;
(ee) Nursing facilities (approved by the DSHS aging and long-term support administration);
(ff) Pathology laboratories;
(gg) Pharmacies;
(hh) Private duty nursing agencies;
(ii) Radiology - Stand-alone clinics;
(jj) Rural health clinics (medicare-certified);
(kk) School districts and educational service districts;
(ll) Sleep study centers; and
(mm) Washington state school districts and educational service districts.
(3) Suppliers of:
(a) Blood, blood products, and related services;
(b) Durable and nondurable medical equipment and supplies;
(c) Complex rehabilitation technologies;
(d) Infusion therapy equipment and supplies;
(e) Prosthetics/orthotics;
(f) Hearing aids; and
(g) Respiratory care, equipment, and supplies.
(4) Contractors:
(a) Transportation brokers;
(b) Spoken language interpreter services agencies;
(c) Independent sign language interpreters; and
(d) Eyeglass and contact lens providers.