WSR 03-24-029

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed November 24, 2003, 3:59 p.m. , effective November 24, 2003 ]

Date of Adoption: November 13, 2003.

Purpose: To continue the emergency rule that has been in place since April 1, 2003, while the permanent rule-making process (initiated under WSR 03-08-081) is completed. The emergency rule reflects the April 1, 2003, federal increase in the federal poverty level (FPL). Federal poverty guidelines are updated annually in the Federal Register by the United States Department of Health and Human Services under Section 673(2) of the Omnibus Budget Reconciliation Act (42 U.S.C. 9902(2)).

Citation of Existing Rules Affected by this Order: Amending WAC 388-478-0085 Medicare savings program -- Monthly income and countable resources standards.

Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.530.

Other Authority: 42 U.S.C. 9902(2).

Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest; and that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.

Reasons for this Finding: Federal statute (42 U.S.C., Chapter 7) requires states to use the annually adjusted FPL guidelines as the basis for determining financial eligibility standards for certain medical assistance programs. The department adopted emergency rules - WSR 03-08-065 and 03-16-021 - to implement the 2003 FPL standards that went into effect on April 1, 2003, per the United States Department of Health and Human Services announcement published in the Federal Register (Volume 68, No. 26, pages 6456-6458). This emergency rule will extend WSR 03-16-021 that would otherwise expire on November 24, 2003. The immediate effective date is needed to prevent a lapse in the applicable FPL that could result in incorrect eligibility determinations for individuals and families in need of medical assistance. The department has filed a preproposal statement of inquiry, WSR 03-08-081, and is taking appropriate steps to adopt the emergency rule as a permanent rule.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 1, Repealed 0; Federal Rules or Standards: New 0, Amended 0, 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 1, Repealed 0.
Effective Date of Rule: November 24, 2003.

November 13, 2003

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3221.1
AMENDATORY SECTION(Amending WSR 01-18-056, filed 8/30/01, effective 9/30/01)

WAC 388-478-0085   Medicare ((cost sharing)) savings 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, ((2001)) 2003, the QMB program's income standards are:


(a) One person $((716))

749

(b) Two persons $((968))

1010


(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, ((2001)) 2003, the SLMB program's income standards are:


Minimum Maximum
(a) One person $((716.01))

749.01

$((859))

898

(b) Two persons $((968.01))

1010.01

$((1161))

1212


(3) The ((expanded special low-income Medicare beneficiary (ESLMB))) qualified individual (QI-1) program income standard is over one hundred twenty percent of FPL, but under one hundred thirty-five percent of FPL. Beginning April 1, ((2001)) 2003, the ESLMB program's income standards are:

Minimum Maximum
(a) One person $((859.01))

898.01

$((967))

1011

(b) Two persons $((1161.01))

1212.01

$((1307))

1364


(4) The qualified disabled working individual (QDWI) program income standard is up to two hundred percent of FPL. Beginning April 1, ((2001)) 2003, the QDWI program's income standards are:


(a) One person $((1432))

1497

(b) Two persons $((1935))

2020

(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, 2001, the QI program's income standards are:


Minimum Maximum
(a) One person $967.01 $1253
(b) Two persons $1307.01 $1694

(6))) The resource standard for the Medicare ((cost sharing)) savings 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 Section 673(2) (42 U.S.C. 9902(2)). 01-18-056, 388-478-0085, filed 8/30/01, effective 9/30/01; 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.]

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