SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)
Preproposal statement of inquiry was filed as WSR 07-09-057.
Title of Rule and Other Identifying Information: WAC 388-535-1065 Coverage limits for dental-related services provided under the General assistance -- Unemployable (GA-U) and Alcoholism and Drug Addiction Treatment and Support Act (ADATSA) programs.
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 http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6097), on August 7, 2007, at 10:00 a.m.
Date of Intended Adoption: Not earlier than August 8, 2007.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504-5850, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail firstname.lastname@example.org, fax (360) 664-6185, by 5:00 p.m. on August 7, 2007.
Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS Rules Consultant, by July 31, 2007,
TTY (360) 664-6178 or (360) 664-6094 or by e-mail at email@example.com.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department is striking "for clients through age twenty" that was inadvertently added in WAC 388-535-1065(4). The corrected rule will read: "Each dental-related procedure described under this section is subject to the coverage limitations listed in chapter 388-535 WAC."
Reasons Supporting Proposal: See above.
Statutory Authority for Adoption: RCW 74.04.050 and 74.08.090.
Statute Being Implemented: RCW 74.04.050 and 74.08.090.
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: Kathy Sayre, 626 8th Avenue, Olympia, WA 98504-5504, (360) 725-1342; Implementation and Enforcement: Dr. John Davis, 626 8th Avenue, Olympia, WA 98504-5504, (360) 725-1748.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rules do not create more than minor costs to small businesses.
A cost-benefit analysis is not required under RCW 34.05.328. The department has determined that the proposed rule does not meet the definition of "significant legislative rule" under RCW 34.05.328, and therefore a cost-benefit analysis is not required. A preliminary cost-benefit analysis may be obtained by contacting Dr. John Davis, P.O. Box 45506, Olympia, WA 98504-5506, phone (360) 725-1748, TYY/TDD 1-800-848-5429, fax (360) 586-1590, e-mail firstname.lastname@example.org.
June 27, 2007
Stephanie E. Schiller
(a) General assistance unemployable (GA-U); and
(b) Alcohol and drug abuse treatment and support act (ADATSA).
(2) The department covers the following dental-related services for a client eligible under the GA-U or ADATSA program:
(a) Services provided only as part of dental treatment for:
(i) Limited oral evaluation;
(ii) Periapical or bite-wing radiographs that are medically necessary to diagnose only the client's chief complaint;
(iii) Palliative treatment to relieve dental pain;
(iv) Pulpal debridement to relieve dental pain; or
(v) Endodontic (root canal only) treatment for maxillary and mandibular anterior teeth (cuspids and incisors) when prior authorized).
(b) Tooth extraction when at least one of the following apply:
(i) The tooth has a radiograph apical lesion;
(ii) The tooth is endodontically involved, infected, or abscessed;
(iii) The tooth is not restorable; or
(iv) The tooth is not periodontally stable.
(3) Tooth extractions require prior authorization when:
(i) The extraction of a tooth or teeth results in the client becoming edentulous in the maxillary arch or mandibular arch; and
(ii) A full mouth extraction is necessary because of radiation therapy for cancer of the head and neck.
(4) Each dental-related procedure described under this
section is subject to the coverage limitations listed in
chapter 388-535 WAC ((
for clients through age twenty)).
(5) The department does not cover any dental-related services not listed in this section for clients eligible under the GA-U or ADATSA program, including any type of removable prosthesis (denture).
[Statutory Authority: RCW 74.08.090, 74.09.500, 74.09.520. 07-06-041, § 388-535-1065, filed 3/1/07, effective 4/1/07. Statutory Authority: RCW 74.04.050, 74.04.057, and 74.09.530. 04-14-100, § 388-535-1065, filed 7/6/04, effective 8/6/04. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, 2003 1st sp.s. c 25, P.L. 104-191. 03-19-077, § 388-535-1065, filed 9/12/03, effective 10/13/03.]