WSR 01-18-056

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed August 30, 2001, 3:56 p.m. ]

Date of Adoption: August 29, 2001.

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. Other changes are to correct and clarify the language in WAC 388-478-0065.

Citation of Existing Rules Affected by this Order: Amending WAC 388-478-0065, 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 01-14-079 on July 3, 2001.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 2, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 3, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 3, Repealed 0.
Effective Date of Rule: Thirty-one days after filing.

August 29, 2001

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

2924.2
AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-478-0065   ((TANF/SFA-related)) Categorically needy income level (CNIL) and resource standards for families.   (1) The categorically needy income level (CNIL) standard for ((TANF-related)) family medical is the same as the grant payment standards for the TANF cash program as stated in WAC 388-478-0020.

(2) The countable resource standards for ((TANF/SFA-related categorically needy (CN))) family medical are the same as those of the TANF/SFA cash program as stated in WAC 388-470-0005.

(3) For all medical programs an unborn child is counted as a household member when determining household size.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-478-0065, filed 7/31/98, effective 9/1/98. Formerly WAC 388-507-0710 and 388-508-0820.]


AMENDATORY SECTION(Amending WSR 00-17-085, filed 8/14/00, effective 9/14/00)

WAC 388-478-0075   Medical programs--Monthly income standards based on the federal poverty level (FPL).   (1) The department bases the income standard upon the Federal Poverty Level (FPL) for the following medical programs:

(a) Children's health program up to one hundred percent of FPL;

(b) Pregnant women's program up to one hundred eighty-five percent of FPL;

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

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

(2) Beginning April 1, ((2000)) 2001, the monthly FPL standards are:


FAMILY

SIZE

 100%

FPL

 185%

FPL

 200%

FPL

 250%

FPL
1 $(( 696)) 716 $ ((1288)) 1325 $ ((1392)) 1432 $ ((1740)) 1790
2 $(( 938)) 968 $ ((1735)) 1790 $ ((1875)) 1935 $ ((2344)) 2419
3 $ ((1180)) 1220 $ ((2182)) 2256 $ ((2359)) 2439 $ ((2948)) 3048
4 $ ((1421)) 1471 $ ((2629)) 2722 $ ((2842)) 2942 $ ((3553)) 3678
5 $ ((1663)) 1723 $ ((3076)) 3187 $ ((3325)) 3445 $ ((4157)) 4307
6 $ ((1905)) 1975 $ ((3523)) 3653 $ ((3809)) 3949 $ ((4761)) 4936
7 $ ((2146)) 2226 $ ((3970)) 4118 $ ((4292)) 4452 $ ((5365)) 5565
8 $ ((2388)) 2478 $ ((4417)) 4584 $ ((4775)) 4955 $ ((5969)) 6194
9 $ ((2630)) 2730 $ ((4864)) 5094 $ ((5259)) 5459 $ ((6573)) 6823
10 $ ((2871)) 2981 $ ((5312)) 5515 $ ((5742)) 5962 $ ((7178)) 7453
Add to the ten person standard for each person over ten:
$ ((242)) 252 $ ((448)) 466 $ ((484)) 504 $ ((605)) 630

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

[Statutory Authority: 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)). 00-17-085, 388-478-0075, filed 8/14/00, effective 9/14/00; 99-19-005, 388-478-0075, filed 9/3/99, effective 10/4/99. 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 00-17-085, filed 8/14/00, effective 9/14/00)

WAC 388-478-0085   Medicare cost sharing programs--Monthly income and countable resources standards.   (1) The qualified Medicare beneficiary (QMB) program income standard is up to one hundred percent of the Federal Poverty Level (FPL). Beginning April 1, ((2000)) 2001, the QMB program's income standards are:


(a) One person $ ((696)) 716
(b) Two persons $ ((938)) 968

(2) The special low-income Medicare beneficiary (SLMB) program income standard is over one hundred percent of FPL, but under one hundred twenty percent of FPL. Beginning April 1, ((2000)) 2001, the SLMB program's income standards are:


Minimum Maximum
(a) One person $ ((696.01)) 716.01 $ ((835)) 859
(b) Two persons $ ((938.01)) 968.01 $ ((1125)) 1161

(3) The expanded special low-income Medicare beneficiary (ESLMB) program income standard is over one hundred twenty percent of FPL, but under one hundred thirty-five percent of FPL. Beginning April 1, ((2000)) 2001, the ESLMB program's income standards are:

Minimum Maximum
(a) One person $ ((835.01)) 859.01 $ ((940)) 967
(b) Two persons $ ((1125.01)) 1161.01 $ ((1266)) 1307

(4) The qualified disabled working individual (QDWI) program income standard is up to two hundred percent of FPL. Beginning April 1, ((2000)) 2001, the QDWI program's income standards are:


(a) One person $ ((1392)) 1432
(b) Two persons $ ((1875)) 1935

(5) The qualified individual (QI) program income standard is over one hundred thirty-five percent of FPL, but under one hundred seventy-five percent of FPL. Beginning April 1, ((2000)) 2001, the QI program's income standards are:


Minimum Maximum
(a) One person $ ((940.01)) 967.01 $ ((1218)) 1253
(b) Two persons $ ((1266.01)) 1307.01 $ ((1641)) 1694

(6) The resource standard for the Medicare cost sharing programs in this section is:


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

[Statutory Authority: 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)). 00-17-085, 388-478-0085, filed 8/14/00, effective 9/14/00; 99-19-005, 388-478-0085, filed 9/3/99, effective 10/4/99. 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