WSR 04-07-167

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Services Administration)

[ Filed March 23, 2004, 3:44 p.m. , effective April 1, 2004 ]

     Date of Adoption: March 15, 2004.

     Purpose: To update the Medicare savings program standards based on a change in federal rules to the federal poverty level (FPL) effective April 1, 2004.

     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: Federal Register, Volume 69, No. 30; 42 U.S.C., chapter 7.

     Under RCW 34.05.350 the agency for good cause finds 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: The increase in the federal poverty level (FPL) must be effective as of April 1, 2004, in order to stay in compliance with federal Medicaid requirements. Federal statute (42 U.S.C., chapter 7) requires states to use the annually adjusted federal poverty level (FPL) guidelines as the basis for determining financial eligibility standards for certain medical assistance programs.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 1, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.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: April 1, 2004.

March 15, 2004

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3221.2
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)) 2004, the QMB program's income standards are:


(a) One person $((716)) 776
(b) Two persons $((968)) 1041

     (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)) 2004, the SLMB program's income standards are:


Minimum Maximum
(a) One person $((716.01)) 776.01 $((859))

931
(b) Two persons $((968.01)) 1041.01 $((1161))

1249

     (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)) 2004, the ((ESLMB)) QI-1 program's income standards are:

Minimum Maximum
(a) One person $((859.01)) 931.01 $((967))

1048
(b) Two persons $((1161.01)) 1249.01 $((1307))

1406

     (4) The qualified disabled working individual (QDWI) program income standard is up to two hundred percent of FPL. Beginning April 1, ((2001)) 2004, the QDWI program's income standards are:


(a) One person $((1432)) 1552
(b) Two persons $((1935)) 2082

     (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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