WSR 99-19-005

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed September 3, 1999, 3:46 p.m. ]

Date of Adoption: September 3, 1999.

Purpose: These amendments change income standards to reflect the new federal poverty level (FPL). These changes will increase the number of people eligible for the medical programs based on the FPL, pregnant women, children and those eligible for Medicare cost sharing programs.

Citation of Existing Rules Affected by this Order: Amending WAC 388-478-0075 and 388-478-0085.

Statutory Authority for Adoption: RCW 74.08.090, 74.04.050, 74.04.057, 74.09.530 and the poverty guidelines updated annually in the Federal Register by the United States Department of Health and Human Services under authority of Section 673(2) of the Omnibus Budget Reconciliation Act (42 U.S.C. 9902(2)).

Adopted under notice filed as WSR 99-15-044 on July 15, 1999.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 2, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 0. Effective Date of Rule: Thirty-one days after filing.

September 3, 1999

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit

2542.6
AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-478-0075
Medical programs--Monthly income standards ((for)) based on the federal poverty level ((income based programs)) (FPL).

(1) The department bases the income ((eligibility)) standard upon the Federal Poverty Level (FPL) for the following medical programs ((is based upon the Federal Poverty Level (FPL) as established by the U.S. Department of Labor and updated annually)):

(a) Children's health program is one hundred percent of FPL((,));

(b) Pregnant women's program is one hundred eighty-five percent of FPL((, and));

(c) Children's categorically needy program is two hundred percent of FPL; and

(d) The children's health insurance program (CHIP), effective January 1, 2000, is over two hundred percent of FPL but under two hundred fifty percent of FPL.

(2) ((The FPL is effective as of)) Beginning April 1, ((1998.)) 1999, the monthly FPL standards are:


FAMILY

SIZE

100%

FPL

185% FPL 200% FPL 250%

FPL

1 $ ((671)) 687 $((1242)) 1271 $((1342)) 1374 $1717
2 $ ((905)) 922 $((1673)) 1706 $((1809)) 1844 $2305
3 $((1138)) 1157 $((2105)) 2140 $((2275)) 2314 $2892
4 $((1371)) 1392 $((2537)) 2575 $((2742)) 2784 $3480
5 $((1605)) 1627 $((2968)) 3010 $((3209)) 3254 $4067
6 $((1838)) 1862 $((3400)) 3445 $((3675)) 3724 $4655
7 $((2071)) 2097 $((3832)) 3879 $((4142)) 4194 $5242
8 $((2305)) 2332 $((4263)) 4314 $((4609)) 4664 $5830
9 $((2538)) 2567 $((4695)) 4749 $((5075)) 5134 $6417
10 $((2771)) 2802 $((5127)) 5184 $((5542)) 5604 $7005
Add to the ten person standard for each person over ten:
$ ((234)) 235 $ ((432)) 435 $((467)) 470 $588

(3) There are no resource limits for the programs under this section.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-478-0075, filed 7/31/98, effective 9/1/98. Formerly WAC 388-507-0805, 388-508-0810, 388-509-0910, 388-509-0920, 388-509-0940 and 388-509-0960.]


AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-478-0085
Medicare cost sharing programs--Monthly income and countable resources standards.

(1) The qualified Medicare beneficiary (QMB) program income standard is ((based upon)) one hundred percent of the Federal Poverty Level (FPL). Beginning April 1, ((1998, this)) 1999, the QMB program's income standards are:


(a) One person $ ((671)) 687
(b) Two persons $ ((905)) 922

(2) The special low-income Medicare beneficiary (SLMB) program income standard is over one hundred percent of ((the)) FPL, but under one hundred twenty percent of ((the)) FPL. Beginning April 1, ((1998, this)) 1999, the SLMB program's income standards are:


Minimum Maximum
(a) One person $ ((671.01)) 687.01 $ ((805)) 824
(b) Two persons $ ((905.01)) 922.01 $((1085)) 1106

(3) The expanded special low-income Medicare beneficiary (ESLMB) program income standard is over one hundred twenty percent of ((the)) FPL, but under one hundred thirty-five percent of ((the)) FPL. Beginning April 1, ((1998, this)) 1999, the ESLMB program's income standards are:

Minimum Maximum
(a) One person $ ((805.01)) 824.01 $ ((906)) 927
(b) Two persons $((1085.01)) 1106.01 $((1221)) 1245

(4) The qualified disabled working individual (QDWI) program income standard is standard is based upon two hundred percent of ((the)) FPL. Beginning April 1, ((1998, this)) 1999, the QDWI program's income standards are:


(a) One person $((1342)) 1374
(b) Two persons $((1809)) 1844

(5) The qualified individual (QI) program income standard is over one hundred thirty-five percent of ((the)) FPL, but under one hundred seventy-five percent of ((the)) FPL. Beginning April 1, ((1998 this)) 1999, the QI program's income standards are:


Minimum Maximum
(a) One person $ ((906.01)) 927.01 $((1174)) 1202
(b) Two persons $((1221.01)) 1245.01 $((1583)) 1613

(6) The ((countable)) resource standard((s)) for ((all of)) the Medicare cost sharing programs in this section((s are the same. These resource standards are)) is:


(a) One person $4000
(b) Two persons $6000

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-478-0085, filed 7/31/98, effective 9/1/98. Formerly WAC 388-517-1715, 388-517-1730, 388-517-1750 and 388-517-1770.]

Washington State Code Reviser's Office