PREPROPOSAL STATEMENT OF INQUIRY
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Subject of Possible Rule Making: WAC 388-543-1000 Definitions for DME and related supplies, prosthetics, and orthotics, medical supplies and related supplies, 388-543-1100 Scope of coverage and coverage limitations for DME and related supplies, prosthetics, orthotics, medical supplies and related services, 388-543-1150 Limits and limitation extensions, 388-543-1400 General reimbursement for DME and related services, prosthetics, orthotics, medical supplies and related services, 388-543-1500 When MAA purchases DME and related supplies, prosthetics and orthotics, 388-543-2100 Wheelchairs -- Reimbursement methodology, 388-543-2500 Reimbursement methodology for other DME, 388-543-2900 Medical supplies and nondurable medical equipment (MSE) -- Reimbursement methodology, and other related WACs.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 74.04.050, 74.04.57 [74.04.057], 74.08.090.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The department is:
• Updating reimbursement methodologies for medical supplies and nondurable medical equipment, wheelchairs and wheelchair accessories, and for other DME;
• Adding definitions;
• Moving policy information from reimbursement methodology sections to policy sections under WAC 388-543-1100;
• Adding "washable protective underwear" to list of diapers and related supplies under WAC 388-543-1150;
• Clarifying the standard specifications for diapers, pull up pants, briefs, washable protective underwear, underpads, liners and undergarment under WAC 388-543-1150;
• Clarifying products that cannot be used together under WAC 388-543-1150; and
• Removing the word "unwilling" from WAC 388-543-1500 (5)(b) and (6)(b).
During the course of this review, MAA may identify additional changes that are required in order to improve clarity or to update policy.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.
Process for Developing New Rule: The department invites the interested public to review and provide input on the draft language of this rule. Draft material and information about how to participate may be obtained from the department representative listed below.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Wendy L. Boedigheimer, Rules Program Manager, Medical Assistance Administration, Rules and Publications Section, P.O. Box 45533, Olympia, WA 98504-5533, phone (360) 725-1306, fax (360) 586-9727, TTY 1-800-848-5429, e-mail boediwl@dshs.wa.gov.
November 15, 2004
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit