WSR 06-22-031



(Health and Recovery Services Administration)

(Medical Assistance)

[ Filed October 25, 2006, 1:57 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 06-14-042.

Title of Rule and Other Identifying Information: WAC 388-490-0005 The department requires proof before authorizing benefits for cash, medical, and Basic Food.

Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane. A map or directions are available at or by calling (360) 664-6097), on December 5, 2006, at 10:00 a.m.

Date of Intended Adoption: Not sooner than December 6, 2006.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail, fax (360) 664-6185, by 5:00 p.m. on December 5, 2006.

Assistance for Persons with Disabilities: Contact Stephanie Schiller, DSHS Rules Consultant, by December 1, 2006, TTY (360) 664-6178 or (360) 664-6097 or by e-mail at

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The federal Deficit Reduction Act of 2005 (Public Law 109-171, Section 6036) requires states to obtain documentation of citizenship and identity for all applicants for and recipients of Medicaid.

Reasons Supporting Proposal: The department is proposing these amendments to ensure continuation of federal funding for the state's Medicaid program.

Statutory Authority for Adoption: RCW 74.04.057, 74.04.090, 74.08.090 and Public Law 109-171, Section 6036.

Statute Being Implemented: Public Law 109-171, Section 6036.

Rule is necessary because of federal law, Public Law 109-171, Section 6036.

Name of Proponent: Department of social and health services, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Joanie Scotson, P.O. Box 45534, Olympia, WA 98504-5534, e-mail, fax (360) 664-0910, (360) 725-1330.

No small business economic impact statement has been prepared under chapter 19.85 RCW. This rule does not affect small businesses.

A cost-benefit analysis is not required under RCW 34.05.328. DSHS client eligibility rules for medical assistance are exempt from this requirement according to RCW 34.05.328 (5)[(b)](vii).

October 20, 2006

Andy Fernando, Manager

Rules and Policies Assistance Unit

AMENDATORY SECTION(Amending WSR 03-21-029, filed 10/7/03, effective 11/1/03)

WAC 388-490-0005   The department requires proof before authorizing benefits for cash, medical, and Basic Food.   This rule applies to cash, medical, and Basic Food.

(1) When you first apply for benefits, the department may require you to provide proof of things that help us decide if you are eligible for benefits. This is also called "verification." The types of things that need to be proven are different for each program.

(2) After that, we will ask you to give us proof when:

(a) You report a change;

(b) We find out that your circumstances have changed; or

(c) The information we have is questionable, confusing, or outdated.

(3) Whenever we ask for proof, we will give you a notice as described in WAC 388-458-0020.

(4) You must give us the proof within the time limits described in:

(a) WAC 388-406-0030 if you are applying for benefits; and

(b) WAC 388-458-0020 if you currently receive benefits.

(5) We will accept any proof that you can easily get when it reasonably supports your statement or circumstances. The proof you give to us must:

(a) Clearly relate to what you are trying to prove;

(b) Be from a reliable source; and

(c) Be accurate, complete, and consistent.

(6) We cannot make you give us a specific type or form of proof.

(7) If the only type of proof that you can get costs money, we will pay for it.

(8) If the proof that you give to us is questionable or confusing, we may:

(a) Ask you to give us more proof, which may include providing a collateral statement. A "collateral statement" is from someone outside of your residence who knows your situation;

(b) Schedule a visit to come to your home and verify your circumstances; or

(c) Send an investigator from the Division of Fraud Investigations (DFI) to make an unannounced visit to your home to verify your circumstances.

(9) By signing the application, eligibility review, or change of circumstances form, you give us permission to contact other people, agencies, or institutions.

(10) If you do not give us all of the proof that we have asked for, we will determine if you are eligible based on the information that we already have. If we cannot determine that you are eligible based on this information, we will deny or stop your benefits.

(11) For all Medicaid programs, you must provide proof of citizenship and identity as specified at Section 6036 of the Deficit Reduction Act of 2005 (PL 106-171 amending USC 1396b). Exempt from this requirement are recipients of:

(a) SSI cash benefits; or

(b) Medicare.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, and 74.04.510. 03-21-029, 388-490-0005, filed 10/7/03, effective 11/1/03. Statutory Authority: RCW 74.08.090 and 74.04.510. 00-08-091, 388-490-0005, filed 4/5/00, effective 5/6/00. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-490-0005, filed 7/31/98, effective 9/1/98. Formerly WAC 388-504-0460.]

Washington State Code Reviser's Office