PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 04-07-087.
Title of Rule and Other Identifying Information: WAC 388-544-0010, 388-544-0050, 388-544-0100, 388-544-0150, 388-544-0200, 388-544-0250, 388-544-0300, 388-544-0350, 388-544-0400, 388-544-0450, 388-544-0475, 388-544-0500, 388-544-0550, and 388-544-0600, vision care services.
Hearing Location(s): Blake Office Park East (behind Goodyear Courtesy Tire), Rose Room, 4500 10th Avenue S.E., Lacey, WA, on May 24, 2005, at 10:00 a.m.
Date of Intended Adoption: Not sooner than May 25, 2005.
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., May 24, 2005.
Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator by May 20, 2005, TTY (360) 664-6178 or (360) 664-6097.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: This WAC revision is intended to accomplish several objectives:
| • | Aligning MAA policies with industry standard when applicable; |
| • | Clarifying vision care coverage; |
| • | Clarifying client eligibility; |
| • | Updating and clarifying wording in the definition section; |
| • | Adding "ocularists" to eligible provider types; |
| • | Adding policy regarding unclaimed hardware and contact lenses; |
| • | Updating noncovered section; |
| • | Clarifying sphere power and diopter guidelines as per stakeholders' responses; |
| • | Clarifying coverage for back-up glasses for clients with developmental disabilities; |
| • | Clarifying medical criteria for durable and flexible frames; |
| • | Outlining coverage for scratch resistant coating for all plastic lenses; |
| • | Updating replacement lense(s) allowances; |
| • | Updating diagnoses for photochromatic lenses; |
| • | Adding coverage for infants and toddlers with motor ataxia for polycarbonate lenses; |
| • | Expanding coverage of contact lenses to include monthly and quarterly wear disposable; |
| • | Discontinuing coverage of glass lenses; |
| • | Updating cataract surgery conditions; and |
| • | Updating expedited prior authorization section. |
Reasons Supporting Proposal: See above.
Statutory Authority for Adoption: RCW 74.08.090, 74.09.510, and 74.09.520; 42 C.F.R. 440.120, 42 C.F.R. 440.225.
Statute Being Implemented: 42 C.F.R. 440.225.
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: Wendy L. Boedigheimer, P.O. Box 45533, Olympia, WA 98504-5533, (360) 725-1306; Implementation and Enforcement: Marlene Black, P.O. Box 45506, Olympia, WA 98504-5506, (360) 725-1577.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has determined that the proposed rule will not create more than minor costs for affected small businesses.
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Marlene Black, Division of Medical Management, P.O. Box 45506, Olympia, WA 98504-5506, phone (360) 725-1577, fax (360) 586-8827, e-mail blackml@dshs.wa.gov.
March 31, 2005
Andy Fernando, 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 05-09 issue of the Register.