WSR 04-09-001

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed April 7, 2004, 4:03 p.m. ]

Date of Adoption: April 7, 2004.

Purpose: This rule increases the standards based on the federal poverty level (FPL) effective April 1, 2004, based on the standards published in the Federal Register, Vol. 69, No. 30.

This replaces the emergency rule filed as WSR 04-07-143 on March 22, 2004, that contained an incorrect effective date for the current FPL standards.

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

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

Other Authority: Federal Register, Volume 69, Number 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 FPL must be effective by April 1, 2004, to comply with federal 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Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 1, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.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

April 7, 2004

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3371.2
AMENDATORY SECTION(Amending WSR 03-15-088, filed 7/17/03, effective 7/17/03)

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

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

(c) Healthcare for workers with disabilities (HWD) up to two hundred twenty percent of FPL; and

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

(2) The department uses the FPL income standards to determine:

(a) The mandatory or optional Medicaid status of an individual; and

(b) Premium amount, if any, for a Medicaid child.

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

(4) Beginning ((April 1, 2003)) April 1, 2004, the monthly FPL standards are:


((
FAMILY

SIZE

100%

FPL

185%

FPL

200%

FPL

220%

FPL

250%

FPL

1 $749 $1385 $1497 $1647 $1871
2 $1010 $1869 $2020 $2222 $2525
3 $1272 $2353 $2544 $2798 $3180
4 $1534 $2837 $3067 $3374 $3834
5 $1795 $3321 $3590 $3949 $4488
6 $2057 $3805 $4114 $4525 $5142
7 $2319 $4289 $4637 $5101 $5796
8 $2580 $4773 $5160 $5676 $6450
9 $2842 $5258 $5684 $6252 $7105
10 $3104 $5742 $6207 $6828 $7759
Add to the ten person standard for each person over ten:
$262 $485 $524 $576 $655
))
FAMILY SIZE 100% FPL Benchmark 133% FPL 150% FPL 185% FPL 200% FPL 220% FPL 250% FPL
1 $ 776 $1032 $1164 $1436 $1552 $1707 $1940
2 $1041 $1385 $1562 $1926 $2082 $2290 $2603
3 $1306 $1737 $1953 $2416 $2612 $2873 $3265
4 $1571 $2090 $2357 $2907 $3142 $3456 $3928
5 $1836 $2442 $2754 $3397 $3672 $4039 $4590
6 $2101 $2795 $3152 $3887 $4202 $4622 $5253
7 $2366 $3147 $3549 $4377 $4732 $5205 $5915
8 $2631 $3499 $3947 $4868 $5262 $5788 $6578
9 $2896 $3852 $4344 $5358 $5792 $6371 $7240
10 $3161 $4204 $4742 $5848 $6322 $6954 $7903
Add to the ten person standard for each person over ten:
$ 265 $353 $398 $ 491 $530 $583 $663

(((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 42 U.S.C. 9902(2). 03-15-088, 388-478-0075, filed 7/17/03, effective 7/17/03. Statutory Authority: RCW 74.08.090, 74.08A.100, 74.09.080, and 74.09.415. 02-17-030, 388-478-0075, filed 8/12/02, effective 9/12/02. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.500, 74.09.510, and Section 1902 (a)(10)(A)(ii)(XV) and (XVI) of the Social Security Act. 02-07-090, 388-478-0075, filed 3/19/02, effective 4/1/02. 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, 388-478-0075, filed 8/30/01, effective 9/30/01; 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.]

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