PERMANENT RULES
SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)
Effective Date of Rule: Thirty-one days after filing.
Purpose: The rule is being amended to: (1) Change program name to patient review and coordination program (PRC), (2) expand program definitions, (3) clarify restrictions, (4) add a requirement that the PRC clients remain enrolled in the managed care plans for one year, and (5) clarify client dispute resolution process.
Citation of Existing Rules Affected by this Order: Amending WAC 388-501-0135.
Statutory Authority for Adoption: RCW 74.08.090.
Other Authority: 42 C.F.R. 431.51, 431.54(e) and 456.1; 42 U.S.C. 1396n.
Adopted under notice filed as WSR 08-01-085 on December 17, 2007.
Changes Other than Editing from Proposed to Adopted Version:
• | In subsection (6)(c): Replaced "in the previous twelve months" with "in a period of ninety consecutive days in the previous twelve months." |
• | In subsection (6)(d): Replaced "within a one-year period" with "in a period of ninety consecutive days in the previous twelve moths [months].["] |
A final cost-benefit analysis is available by contacting Trang Kuss, P.O. Box 45532, Olympia, WA 98504, phone (360) 725-1391, fax (360) 725-1969. The preliminary cost-benefit analysis (CBA) stands as the final CBA.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: February 7, 2008.
Robin Arnold-Williams
Secretary
3933.6(a) PRC applies to medical assistance fee-for-service and managed care clients. PRC does not apply to clients eligible for the family planning only program.
(b) PRC is authorized under federal Medicaid law by 42 USC 1396n (a)(2) and 42 CFR 431.54.
(2) Definitions. The following definitions apply to this section only:
"Appropriate use" ((means)) - Use of ((health care))
healthcare services that are adapted to or appropriate for a
client's ((or enrollee's medical)) healthcare needs.
"Assigned provider" ((means)) - A department-enrolled
healthcare provider or one participating with a department
contracted managed care organization (MCO) ((contracted
medical provider)) who agrees to be assigned as a primary
provider and coordinator of services for a ((medical
assistance)) fee-for-service or managed care client ((or MCO
enrollee)) in the ((PRR)) PRC program. Assigned providers can
include a primary care provider (PCP), a pharmacy, a
((narcotic)) controlled substances prescriber, and((,)) a
hospital for ((nonemergency medical)) nonemergent hospital
services((, a hospital)).
"At-risk" ((means a medical history that may include))
- A term used to describe one or more of the following:
(a) A client with a medical history of:
• ((Indicators)) Indications of forging or altering
prescriptions;
• Seeking and/or obtaining ((medical)) healthcare
services at a frequency or amount that is not medically
necessary;
• ((Indicators of potentially)) Potential
life-threatening events or life-threatening conditions that
required or may require medical intervention((;
• A client's or enrollee's medical assistance identification card reportedly used by an unauthorized person(s) or for an unauthorized purpose(s); or
•)).
(b) ((Other)) Behaviors or practices that could
jeopardize a client's ((or enrollee's)) medical treatment or
health including, but not limited to:
• Referrals from social services personnel about inappropriate behaviors or practices that places the client at risk;
• Noncompliance with treatment;
• Paying cash for controlled substances;
• Positive urine drug screen for illicit street drugs or nonprescribed controlled substances; or
• Unauthorized use of a client's medical assistance identification card or for an unauthorized purpose.
"Care management" - Services provided to clients with multiple health, behavioral, and social needs in order to improve care coordination, client education, and client self-management skills.
"Client" - A person enrolled in a department healthcare program and receiving service from fee-for-service provider(s) or a managed care organization (MCO), contracted with the department.
"Conflicting" ((means)) - Drugs and/or ((health care))
healthcare services that are incompatible and/or unsuitable
for use together because of undesirable chemical or
physiological effects.
"Contraindicated" ((means)) - To indicate or show
((that)) a medical treatment or procedure is inadvisable or
not recommended or warranted.
"Controlled substances prescriber" - Any of the following healthcare professionals who, within their scope of professional practice, are licensed to prescribe and administer controlled substances (see chapter 69.50 RCW, uniform controlled substance act) for a legitimate medical purpose:
• A physician under chapter 18.71 RCW;
• A physician assistant under chapter 18.71A RCW;
• An osteopathic physician under chapter 18.57 RCW;
• An osteopathic physician assistant under chapter 18.57A RCW; and
• An advanced registered nurse practitioner under chapter 18.79 RCW.
"Duplicative" - Applies to the use of the same or similar
drugs and ((health care)) healthcare services without due
justification. Example: A client (((or MCO enrollee)))
receives ((health care)) healthcare services from two or more
providers for the same or similar condition(s) in an
overlapping time frame, or the client receives two or more
similarly acting drugs in an overlapping time frame, which
could result in a harmful drug interaction or an adverse
reaction.
"Just cause" - A legitimate reason to justify the action taken, including but not limited to, protecting the health and safety of the client.
"Managed care organization" or "MCO" ((means)) - An
organization having a certificate of authority or certificate
of registration from the office of insurance commissioner,
that contracts with the department under a comprehensive risk
contract to provide prepaid ((health care)) healthcare
services to eligible medical assistance clients under the
department's managed care programs.
"((MCO enrollee)) Managed care client" ((means)) - A
medical assistance client enrolled in, and receiving
((medical)) healthcare services from, a department-contracted
managed care organization (MCO).
(("Narcotic prescriber" means any of the following health
care professionals who, within their scope of professional
practice, are licensed to prescribe and administer controlled
substances (see chapter 69.50 RCW, Uniform Controlled
Substance Act) for a legitimate medical purpose:
• A physician under chapter 18.71 RCW;
• A physician assistant under chapter 18.71A RCW;
• An osteopathic physician under chapter 18.57 RCW;
• An osteopathic physician assistant under chapter 18.57A RCW; and
• An advanced registered nurse practitioner under chapter 18.79 RCW.))
"Primary care provider" or "PCP" ((means)) - A person
licensed or certified under title 18 RCW including, but not
limited to, a physician, an advanced registered nurse
practitioner (ARNP), or a physician assistant who supervises,
coordinates, and provides ((health care)) healthcare services
to a client ((or an MCO enrollee)), initiates referrals for
specialty and ancillary care, and maintains the client's ((or
enrollee's)) continuity of care.
(3) ((Restrictions under the PRR program:
(a) Do not apply to a client eligible for a family planning only program; and
(b) Do apply to a fee-for-service client or an MCO enrollee currently assigned to the PRR program)) Clients selected for PRC review. The department or MCO selects a client for PRC review when either or both of the following occur:
(a) A utilization review report indicates the client has not utilized healthcare services appropriately; or
(b) Medical providers, social service agencies, or other concerned parties have provided direct referrals to the department or MCO.
(4) When a fee-for-service client is selected for PRC
review the prior authorization process ((described in WAC 388-530-1250)) as defined in chapter 388-530 WAC may be
required ((for a fee-for-service client)):
(a) Prior to or during a ((PRR)) PRC review; or
(b) When currently ((placed)) in the ((PRR)) PRC program.
(5) ((Clients selected for PRR review. The department or
MCO selects a fee-for-service client or MCO enrollee for PRR
review when either or both of the following occur:
(a) A utilization review report indicates the client or enrollee has utilized health care services as described in subsection (6) of this section; or
(b) Medical providers, social service agencies, or other concerned parties have provided direct referrals to the department or MCO.
(6))) ((PRR)) Review for placement in the ((PRR)) PRC
program. When the department or MCO selects a client ((or
enrollee)) for ((PRR)) PRC review, the department or MCO
staff, with clinical oversight, reviews a client's ((or
enrollee's)) medical and/or billing history to determine if
the client ((or enrollee)) has utilized ((medical)) healthcare
services at a frequency or amount that is not medically
necessary (42 CFR 431.54(e)). ((The utilization guidelines in
subsection (7) of this section establish that a client or
enrollee has utilized medical services at a frequency or
amount that is not medically necessary when:
(a) There is a history of medical services that are duplicative, excessive, or contraindicated;
(b) There is a history of conflicting health care services, drugs, or supplies that are not within acceptable medical practice; or
(c) The medical history shows indicators of "at-risk" utilization patterns.
(7))) (6) Utilization guidelines for ((PRR)) PRC
placement. Department ((and)) or MCO staff use the following
utilization guidelines to determine ((PRR)) PRC placement
((and)). A client may be placed ((a client or enrollee)) in
the ((PRR)) PRC program when medical and/or billing histories
document any of the following:
(a) Any two or more of the following conditions occurred
in a period of ninety consecutive calendar days in the
previous twelve months. The client ((or enrollee)):
(i) Received services from four or more different providers, including physicians, advanced registered nurse practitioners (ARNPs), and physician assistants (PAs);
(ii) Had prescriptions filled by four or more different pharmacies;
(iii) Received ten or more prescriptions;
(iv) Had prescriptions written by four or more different prescribers;
(v) Received similar services from two or more providers in the same day; or
(vi) Had ten or more office visits.
(b) Any one of the following occurred within a period of
ninety consecutive calendar days in the previous twelve
months. The client ((or enrollee has)):
(i) Made two or more emergency department visits;
(ii) Has a medical history that indicates "at-risk" utilization patterns;
(iii) Made repeated and documented efforts to seek
((health care)) healthcare services that are not medically
necessary; or
(iv) Has been counseled at least once by a health care
provider, or a department or MCO staff member, with clinical
oversight, about the appropriate use of ((health care))
healthcare services.
(c) The client ((or enrollee)) received prescriptions for
controlled substances from two or more different prescribers
in any one month in a period of ninety consecutive days in the
previous twelve months.
(d) The client's medical and/or billing history demonstrates a pattern of the following at any time in the previous twelve months:
(i) The client has a history of using healthcare services in a manner that is duplicative, excessive, or contraindicated; or
(ii) The client has a history of receiving conflicting healthcare services, drugs, or supplies that are not within acceptable medical practice.
(((8))) (7) ((PRR)) PRC review ((outcomes)) results. As
a result of the ((PRR)) PRC review, the department or MCO
staff may take any of the following steps:
(a) Determine that no action is needed and close the
client's ((or enrollee's)) file;
(b) Send the client ((or enrollee)) and, if applicable,
the client's ((or enrollee's)) authorized representative, a
letter of concern with information on specific findings and
notice of potential placement in the ((PRR)) PRC program; or
(c) Determine that the utilization guidelines for ((PRR))
PRC placement establish that the client ((or enrollee)) has
utilized ((medical)) healthcare services at an amount or
frequency that is not medically necessary ((and)), in which
case the department or MCO will take one or more of the
following actions((. The department or MCO staff)):
(i) Refer((s)) the client ((or enrollee)) for education
on appropriate use of ((health care)) healthcare services;
(ii) Refer((s)) the client ((or enrollee)) to other
support services or agencies; or
(iii) Place((s)) the client ((or enrollee)) into the
((PRR)) PRC program for an initial ((restriction)) placement
period of twenty-four months.
(((9))) (8) ((PRR)) Initial placement in the PRC program
((placement)). When a ((fee-for-service)) client ((or MCO
enrollee)) is initially placed in the ((PRR)) PRC program((,
the department or the MCO sends the client or enrollee and, if
applicable, the client's or enrollee's authorized
representative, a written notice of the PRR placement that:
(a) Informs the client or the enrollee of the reason for the PRR program placement.
(b) Restricts)):
(a) The department or MCO places the client ((or
enrollee)) for twenty-four months ((to)) with one or more of
the following types of ((providers when obtaining health care
services)) healthcare providers:
(i) Primary care ((physician)) provider (PCP) (as defined
in subsection (2) of this section);
(ii) Pharmacy;
(iii) ((Narcotic)) Controlled substances prescriber;
(iv) Hospital (for ((nonemergency medical)) nonemergent
hospital services); or
(v) Another qualified ((provider-type)) provider type, as
determined by department or MCO program staff on a
case-by-case basis.
(((c) Directs the client or enrollee to respond to the
department or the MCO within ten days of the date of the
written notice:
(i) To select providers, subject to department or MCO approval;
(ii) To submit additional medical information, justifying the client's or enrollee's use of medical services; or
(iii) To request assistance, if needed, from the department or MCO program staff.
(d) Informs the client or enrollee of hearing rights (see subsection (14) of this section).
(e) Informs the client or enrollee that if a response is not received within ten days of the date of the notice, the client or enrollee will be assigned providers.
(f) Informs the client or enrollee of the rules that support the decision)) (b) The managed care client will remain in the same MCO for no less than twelve months unless:
(i) The client moves to a residence outside the MCO's service area and the MCO is not available in the new location; or
(ii) The client's assigned provider no longer participates with the MCO and is available in another MCO, and the client wishes to remain with the current provider.
(c) A managed care client placed in the PRC program must remain in the PRC program for the initial twenty-four month period regardless of whether the client changes MCOs or becomes a fee-for-service client.
(d) A care management program may be offered to a client.
(9) Notifying the client about placement in the PRC program. When the client is initially placed in the PRC program, the department or the MCO sends the client and, if applicable, the client's authorized representative, a written notice containing at least the following components:
(a) Informs the client of the reason for the PRC program placement;
(b) Directs the client to respond to the department or MCO within ten business days of the date of the written notice about taking the following actions:
(i) Select providers, subject to department or MCO approval;
(ii) Submit additional healthcare information, justifying the client's use of healthcare services; or
(iii) Request assistance, if needed, from the department or MCO program staff.
(c) Informs the client of hearing or appeal rights (see subsection (14) of this section).
(d) Informs the client that if a response is not received within ten days of the date of the notice, the client will be assigned a provider(s) by the department or MCO.
(10) Selection and role of assigned provider. A
((fee-for-service)) client ((and an MCO enrollee)) may be
afforded a limited choice of providers ((for the types of
services that are to be restricted (see subsection (9)(a) of
this section for a list of provider-types that the department
may assign))).
(a) The following providers are not available:
(i) A provider who is being reviewed by the department or licensing authority regarding quality of care;
(ii) A provider who has been suspended or disqualified from participating as a department-enrolled or MCO-contracted provider; or
(iii) A provider whose business license is suspended or revoked by the licensing authority.
(b) For a ((fee-for-service)) client placed in the
((PRR)) PRC program, the assigned:
(i) Provider(s) must be located in the client's local geographic area, in the client's selected MCO, and/or be reasonably accessible to the client.
(ii) ((Department-enrolled)) Primary care provider (PCP)
supervises and coordinates ((health care)) healthcare services
for the client, including ((providing)) continuity of care and
referrals to specialists when necessary. The PCP must be one
of the following:
(A) A physician who meets the criteria ((under WAC 388-502-0020 and 388-502-0030)) as defined in chapter 388-502 WAC;
(B) An advanced registered nurse practitioner (ARNP) who
meets the criteria ((under WAC 388-502-0020 and 388-502-0030))
as defined in chapter 388-502 WAC; or
(C) A licensed physician assistant (PA), practicing with
a ((sponsored)) supervising physician.
(iii) ((Narcotic)) Controlled substances prescriber
prescribes all controlled substances for the client.
(iv) Pharmacy fills all prescriptions for the client.
(v) Hospital provides all ((nonemergency and outpatient
hospital care for the client)) nonemergent hospital services.
(((b) For an MCO enrollee placed in the PRR program, the
assigned PCP, narcotic prescriber, pharmacy, and hospital must
be:
(i) Available within the enrollee's selected MCO; and
(ii) Located in the enrollee's local geographic area and/or reasonably accessible to the enrollee.))
(c) A client ((or enrollee)) placed in the ((PRR)) PRC
program cannot change assigned providers for twelve months
after the assignments are made, unless:
(i) The client ((or enrollee)) moves to a residence
outside the provider's geographic area;
(ii) The provider moves out of the client's ((or
enrollee's)) local geographic area and is no longer reasonably
accessible to the client ((or enrollee));
(iii) The provider refuses to continue to serve the
client ((or enrollee));
(iv) The client ((or enrollee)) did not select the
provider. The client ((or enrollee)) may request to change an
assigned provider once within thirty calendar days of the
initial assignment;
(v) The ((enrollee's)) client's assigned provider no
longer participates with the MCO. In this case, the
((enrollee)) client may select a new provider from the list of
available providers in the MCO or ((transfer enrollment of all
family members to the new department-contracted MCO that the
established provider has joined;
(vi) The provider has been suspended or disqualified from participating as a department-enrolled or MCO-contracted provider; or
(vii) The provider's business license has been suspended or revoked by the licensing authority;)) follow the assigned provider to the new MCO.
(d) When an assigned prescribing provider no longer contracts with the department:
(i) All prescriptions from the provider are invalid thirty calendar days following the date the contract ends; and
(ii) All prescriptions from the provider are subject to
applicable ((pharmacy)) prescription drugs (outpatient) rules
in chapter 388-530 WAC or appropriate MCO rules((; and)).
(iii) The client ((or enrollee)) must choose or be
assigned another provider according to the requirements in
this section.
(11) ((PRR restriction)) PRC placement periods. The
length of time for a ((fee-for-service)) client's ((or MCO
enrollee's)) PRC placement includes:
(a) The initial ((restriction)) period of ((PRR)) PRC
placement, which is((:
(i) A minimum of twenty-four consecutive months; or
(ii) If the client or enrollee is not eligible for a medical assistance program for any month(s) during the span of the twenty-four consecutive months of PRR placement, the restriction period is for the duration of the client's or enrollee's medical assistance program eligibility plus any subsequent period of eligibility up to but not exceeding twenty-four months;)) a minimum of twenty-four consecutive months.
(b) The second ((restriction)) period of ((PRR)) PRC
placement, which is((:
(i) An additional thirty-six consecutive months; or
(ii) If the client or enrollee is not eligible for a medical assistance program for any month(s) during the span of the thirty-six consecutive months, the restriction period is for the duration of the client's or enrollee's eligibility for a medical assistance program plus any subsequent period of eligibility up to but not exceeding thirty-six months; and)) an additional thirty-six consecutive months.
(c) The third ((restriction)) period and each subsequent
period of ((PRR)) PRC placement, which is((:
(i) An additional seventy-two consecutive months; or
(ii) If the client or enrollee is not eligible for a medical assistance program for any month(s) during the span of the seventy-two consecutive months, the restriction period is for the duration of the client's or enrollee's eligibility for a medical assistance program plus any subsequent period of eligibility up to but not exceeding each seventy-two month placement)) an additional seventy-two months.
(12) Department review of a ((PRR restriction)) PRC
placement period ((assignment)). The department or MCO
reviews a ((fee-for-service)) client's ((or MCO enrollee's))
use of ((health care)) healthcare services prior to the end of
each ((assigned PRR restriction)) PRC placement period
described in subsection (11) of this section using the
utilization guidelines in subsection (((7))) (6) of this
section.
(a) The department or MCO assigns the next ((PRR
restriction)) PRC placement period if the utilization
guidelines for ((PRR)) PRC placement in subsection (((7))) (6)
apply to the client ((or enrollee)).
(b) When the department or MCO assigns a subsequent ((PRR
restriction)) PRC placement period, the department or MCO
sends the client ((or enrollee)) and, if applicable, the
client's ((or enrollee's)) authorized representative, a
written notice ((that informs)) informing the client ((or
enrollee)):
(i) ((Of)) The reason for the subsequent ((PRR)) PRC
program placement;
(ii) ((Of)) The ((period of time)) length of the
subsequent ((PRR)) PRC placement;
(iii) That the current providers assigned to the client
((or enrollee)) continue to be assigned to the client during
the subsequent ((PRR restriction)) PRC placement period;
(iv) That all ((PRR)) PRC program rules continue to
apply; and
(v) Of hearing or appeal rights (see subsection (14) of
this section); ((and))
(vi) Of the rules that support the decision.
(c) The department may ((lift any assigned PRR
restriction period)) remove a client from PRC placement if the
client ((or enrollee)):
(i) Successfully completes a treatment program that is provided by a chemical dependency service provider certified by the department under chapter 388-805 WAC;
(ii) Submits documentation of completion of the approved treatment program to the department; and
(iii) Maintains appropriate use of ((health care))
healthcare services within the utilization guidelines
described in subsection (((7))) (6) for six months after the
date the treatment ends.
(d) ((A client or enrollee who is placed in the PRR
program after being removed from any PRR restriction period
will be placed at the next PRR restriction period described in
subsections (11)(b) and (c) of this section)) The department
or MCO determines the appropriate placement period for a
client who has been placed back into the program.
(e) A client ((or enrollee)) will remain placed in the
((PRR)) PRC program regardless of change in eligibility
program type or change in address.
(13) Client financial responsibility. ((This subsection
takes precedence over WAC 388-502-0160.)) A
((fee-for-service)) client ((or MCO enrollee)) placed in the
((PRR)) PRC program may be billed by a provider and held
financially responsible for ((health care)) healthcare
services when the client ((or enrollee)) obtains
((nonemergency)) nonemergent services and the provider who
renders the services is not assigned or referred under the
((PRR)) PRC program.
(14) Right to hearing or appeal.
(a) A fee-for-service client ((or MCO enrollee)) who
believes the department ((or MCO)) has taken an invalid action
((erroneously)) pursuant to this section may request a
hearing.
(b) A managed care client who believes the MCO has taken an invalid action pursuant to this section or chapter 388-538 WAC must exhaust the MCO's internal appeal process set forth in WAC 388-538-110 prior to requesting a hearing. Managed care clients can not change MCOs until the appeal or hearing is resolved and there is a final ruling.
(((a))) (c) A client ((or enrollee)) must request the
hearing or appeal within ninety calendar days after the client
((or enrollee)) receives the written notice of ((restriction))
placement in the PRC program. ((Chapter 388-538 WAC does not
apply to the department's or MCO's decision to place an
enrollee in the PRR program.
(b))) (d) The department conducts a hearing according to chapter 388-02 WAC. Definitions for the terms "hearing," "initial order," and "final order" used in this subsection are found in WAC 388-02-0010.
(((c))) (e) A client ((or enrollee)) who requests a
hearing or appeal within ten calendar days from the date of
the written notice of an initial ((restriction)) PRC placement
period ((of PRR placement)) under subsection (11)(a) of this
section will not be placed in the ((PRR)) PRC program until
the date an initial order is issued that supports the client's
((or enrollee's)) placement in the ((PRR)) PRC program or
otherwise ordered by an administrative law judge (ALJ).
(((d))) (f) A client ((or enrollee)) who requests a
hearing ((after)) or appeal more than ten calendar days from
the date of the written notice under subsection (((11)(a)))
(9) of this section will remain placed in the ((PRR)) PRC
program unless a final administrative order is entered that
orders ((their)) the client's removal from ((restriction)) the
program.
(((e))) (g) A client ((or enrollee)) who requests a
hearing or appeal within ninety days from the date of
receiving the written notice under subsection (((11)(b) or (c)
or)) (9) of this section and who has already been assigned
providers will remain placed in the ((PRR)) PRC program unless
a final administrative order is entered that orders the
client's ((or enrollee's)) removal from ((restriction)) the
program.
(((f))) (h) An administrative law judge (ALJ) may rule
that the client ((or enrollee)) be placed in the ((PRR)) PRC
program prior to the date the record is closed and prior to
the date the initial order is issued based on a showing of
just cause (((a showing of just cause means it has been
demonstrated that there is a legitimate cause to justify the
action taken) to protect the health and safety of the client
or enrollee)).
(i) The client who requests a hearing challenging placement into the PRC program has the burden of proving the department's or MCO's action was invalid. For standard of proof, see WAC 388-02-0485.
[Statutory Authority: RCW 74.08.090, 74.09.520, 74.04.055, and 42 C.F.R. 431.54. 06-14-062, § 388-501-0135, filed 6/30/06, effective 7/31/06. Statutory Authority: RCW 74.08.090, 74.04.055, and 42 C.F.R. Subpart B 431.51, 431.54 (e) and (3), and 456.1. 04-01-099, § 388-501-0135, filed 12/16/03, effective 1/16/04. Statutory Authority: RCW 74.08.090. 01-02-076, § 388-501-0135, filed 12/29/00, effective 1/29/01. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-501-0135, filed 7/31/98, effective 9/1/98. Statutory Authority: RCW 74.08.090 and 74.09.522. 97-03-038, § 388-501-0135, filed 1/9/97, effective 2/9/97. Statutory Authority: RCW 74.08.090. 94-10-065 (Order 3732), § 388-501-0135, filed 5/3/94, effective 6/3/94. Formerly WAC 388-81-100.]
Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.