PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 04-08-133, 03-07-031, and 01-16-136.
Title of Rule and Other Identifying Information: Chapter 388-96 WAC, Medicaid nursing facility payment system.
Hearing Location(s): Blake Office Park East (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA, on October 5, 2004, at 10:00 a.m.
Date of Intended Adoption: Not earlier than October 6, 2004.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA, e-mail fernaax@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m., October 5, 2004.
Assistance for Persons with Disabilities: Contact Fred Swenson, DSHS Rules Consultant, by October 1, 2004, TTY (360) 664-6178 or (360) 664-6097.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The ADSA Management Services Division (MSD)/Office of Rates Management is implementing 2004 legislative changes (section 913, chapter 276, Laws of 2004) that affect chapter 388-96 WAC, Medicaid nursing facility payment system. This CR-102 is also filed to cover the following CR-101s: WSR 01-16-136 filed July 31, 2001, to implement SHB 2242 (chapter 8, Laws of 2001 1st sp.s.); WSR 03-07-031 filed on March 31, 2003; and WSR 04-08-133 filed on April 7, 2004.
| WAC 388-96-117 | Requiring a perjury statement signed by the contractor and no other signatures. |
| WAC 388-96-217 | Adding a new fine to address nonreporting of Medicaid resident income and resource changes. |
| WAC 388-96-218 | Editing and to comply with RCW 74.46.165 on shifting and overpayment retention. |
| WAC 388-96-369 | Requiring signature of two witnesses resident unable to sign for funds. |
| WAC 388-96-372 | Increasing petty cash to $1000. |
| WAC 388-96-708 and 388-96-709 | Unbanking and banking beds to comply with changes in chapter 74.46 RCW. |
| WAC 388-96-713 | Identifying adjusted cost report data from calendar year 1999 will be used for July 1, 2004 rates. |
| WAC 388-96-714 | Repealing - Nursing facility Medicaid rate allocations -- Economic trends and conditions adjustment factors. |
| WAC 388-96-723, 388-96-724, 388-96-725, 388-96-726, 388-96-730 and 388-96-731 | Removing rate designation as capital/noncapital. |
| WAC 388-96-728 | Repealing - How will the nursing facility's "hold harmless" direct care rate be determined? |
| WAC 388-96-729 | Repealing - When will the department use the "hold harmless rate" to pay for direct care services? |
| WAC 388-96-730 and 388-96-731 | Removing the capital/noncapital designation for payment rates. |
| WAC 388-96-732 | Repealing - How will the department determine whether its notice pursuant to WAC 388-96-724 was timely? |
| WAC 388-96-749 | Adding that the VR rate, quartiles and percentages will not be adjusted following a July 1, rebasing. |
| WAC 388-96-776 | Amending to account for certificates of capital authorizations (CCA). |
| WAC 388-96-779 | Repealing - Exceptional therapy care -- Designated nursing facilities. |
| WAC 388-96-780 | Repealing - Exceptional therapy care -- Covered Medicaid residents. |
| WAC 388-96-783 | Implementing CCA. |
| WAC 388-96-740 | Adding that newly Medicaid not meeting 90% will use industry average Medicaid case mix index. |
| WAC 388-96-742 | Adding that a significant discrepancy exists when census is 50% or less of licensed beds. |
| WAC 388-96-766 | Adding that a contractor is deemed to receive notification five days from date of department notice. |
| WAC 388-96-901 | Revising actions not subject to administrative review. |
Reasons Supporting Proposal: Implementing changes in state law, and editing the rules for clarity, substance and form where appropriate.
Statutory Authority for Adoption: RCW 74.46.431 (11) and (12) and 74.46.800 are statutory authority for all WAC sections in this proposal, except the following: RCW 74.46.431 is the authority for WAC 388-96-713; RCW 74.46.807 and 74.46.431 are the authority for WAC 388-96-783; RCW 74.46.155, 74.46.165, and 74.46.431 are the authority for WAC 388-96-218; and RCW 74.46.050 and 74.46.431 are the authority for WAC 388-96-217.
Statute Being Implemented: Chapter 74.46 RCW; section 913, chapter 276, Laws of 2004; chapter 8, Laws of 2001 1st sp.s.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of Social and Health Services, governmental.
Name of Agency Personnel Responsible for Drafting: Patricia Hague, Mailstop 45600, (360) 725-2447; Implementation: Edward Southon, Mailstop 45600, (360) 725-2472; and Enforcement: Kenneth Callaghan, Mailstop 45600, (360) 725-2469.
No small business economic impact statement has been prepared under chapter 19.85 RCW. Under RCW 19.85.025(3) a small business economic impact statement does not apply to rules that set or adjust fees or rates pursuant to legislative standards. RCW 34.05.310 (4)(f). Chapter 74.46 RCW provides standards to which the rules adopted in chapter 388-96 WAC comply.
A cost-benefit analysis is not required under RCW 34.05.328. Under RCW 34.05.328 (5)(b)(vi), rules that set or adjust fees or rates pursuant to legislative standards are exempt from RCW 34.05.328. Chapter 74.46 RCW provides standards to which the rules adopted in chapter 388-96 WAC comply.
August 17, 2004
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit
Reviser's note: The material contained in this filing exceeded the page-count limitations of WAC 1-21-040 for appearance in this issue of the Register. It will appear in the 04-18 issue of the Register.