WASHINGTON STATE REGISTER

WSR 08-11-031

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed May 13, 2008, 9:59 a.m. , effective June 13, 2008 ]

аааааEffective Date of Rule: Thirty-one days after filing.

аааааPurpose: The proposed changes are intended to describe the changes in program eligibility and scope of care. These rules:

Х Add a definition for comprehensive family planning preventive medicine visit and delayed pelvic protocol;

Х Change text throughout from "over-the-counter (OTC) birth control and supplies" to "over-the-counter (OTC) birth control drugs and supplies";

Х Clearly identify who is eligible for family planning only and TAKE CHARGE;

Х Add language under provider requirements in all sections (reproductive health, family planning only, and TAKE CHARGE) about "referring the client to available and affordable nonfamily planning primary care services, as needed."

Х Strike the language under the covered section for "services for women" under reproductive health that said "cervical, vaginal, and breast cancer screening examination once per year as medically necessary" and expand the language to allow for an annual comprehensive family planning preventive medicine visit and a gynecological examination for any Medicaid client who is seeking and needing family planning. The department is also including the same language under the family planning only sections and TAKE CHARGE. Requirements for the comprehensive family planning preventive medicine visit is also included;

Х Strike the following language under the covered section for services for men under reproductive health: "Prostate cancer screening for men, who are fifty years of age and older, once per year," and change it to read: "Prostate cancer screening for men, once per year, when medically necessary."

Х Add screening and treatment for chlamydia and gonorrhea as part of the comprehensive family planning preventive medicine visit for women thirteen to twenty-five years of age under the covered section for family planning only and TAKE CHARGE;

Х Update the definition for education, counseling and risk reduction intervention (ECRR) in the TAKE CHARGE section and remove the definition for intensive follow-up services.

Х Include federal requirements for TAKE CHARGE eligibility which states that an applicant must provide proof of citizenship or qualified alien status and identity, must need family planning services, and must not be currently covered through another medical assistance program for family planning or have any health insurance that covers family planning.

Х Change language under TAKE CHARGE program provider requirements that the "provider must document that each individual responsible for providing TAKE CHARGE services is trained on all aspects of the TAKE CHARGE program." The word "document" replaces the word "assure."

Х Add "within seven working days of receipt" to the existing requirement for TAKE CHARGE providers to forward the client's medical ID card to them;

Х Include language in the TAKE CHARGE section about "informing the client of their right to see any TAKE CHARGE provider within the state."

Х Incorporate into rule current policy that abortions and other pregnancy-related services are not covered under the TAKE CHARGE program.

Х Change the language under the TAKE CHARGE - good cause exemption section from TAKE CHARGE applicants who are either adolescents or young adults, to "eighteen years of age or younger" and change domestic violence victims to those "domestic violence victims who depend on their spouse's insurance...."

Х Identify when TAKE CHARGE providers are exempt from billing third party [parties].

аааааCitation of Existing Rules Affected by this Order: Amending WAC 388-532-050, 388-532-100, 388-532-110, 388-532-120, 388-532-520, 388-532-530, 388-532-700, 388-532-710, 388-532-720, 388-532-730, 388-532-740, 388-532-750, 388-532-760, 388-532-780, and 388-532-790.

аааааStatutory Authority for Adoption: RCW 74.08.090 and 74.09.800.

ааааа Adopted under notice filed as WSR 08-05-095 on February 15, 2008.

аааааA final cost-benefit analysis is available by contacting Maureen Considine, FP/TC Program Manager, P.O. Box 45530, Olympia, WA 98504-5530, phone (360) 725-1652, fax (360) 586-9727, e-mail consicm@dshs.wa.gov.

аааааNumber 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.

аааааNumber of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

аааааNumber of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

аааааNumber of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 15, Repealed 0.

аааааNumber of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; аааааPilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 15.

аааааDate Adopted: May 12, 2008.

Robin Arnold-Williams

Secretary

аааааReviser'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 08-12 issue of the Register.

Х	Add a definition for comprehensive family planning preventive medicine visit and delayed pelvic protocol;
Х	Change text throughout from "over-the-counter (OTC) birth control and supplies" to "over-the-counter (OTC) birth control drugs and supplies";
Х	Clearly identify who is eligible for family planning only and TAKE CHARGE;
Х	Add language under provider requirements in all sections (reproductive health, family planning only, and TAKE CHARGE) about "referring the client to available and affordable nonfamily planning primary care services, as needed."
Х	Strike the language under the covered section for "services for women" under reproductive health that said "cervical, vaginal, and breast cancer screening examination once per year as medically necessary" and expand the language to allow for an annual comprehensive family planning preventive medicine visit and a gynecological examination for any Medicaid client who is seeking and needing family planning. The department is also including the same language under the family planning only sections and TAKE CHARGE. Requirements for the comprehensive family planning preventive medicine visit is also included;
Х	Strike the following language under the covered section for services for men under reproductive health: "Prostate cancer screening for men, who are fifty years of age and older, once per year," and change it to read: "Prostate cancer screening for men, once per year, when medically necessary."
Х	Add screening and treatment for chlamydia and gonorrhea as part of the comprehensive family planning preventive medicine visit for women thirteen to twenty-five years of age under the covered section for family planning only and TAKE CHARGE;
Х	Update the definition for education, counseling and risk reduction intervention (ECRR) in the TAKE CHARGE section and remove the definition for intensive follow-up services.
Х	Include federal requirements for TAKE CHARGE eligibility which states that an applicant must provide proof of citizenship or qualified alien status and identity, must need family planning services, and must not be currently covered through another medical assistance program for family planning or have any health insurance that covers family planning.
Х	Change language under TAKE CHARGE program provider requirements that the "provider must document that each individual responsible for providing TAKE CHARGE services is trained on all aspects of the TAKE CHARGE program." The word "document" replaces the word "assure."
Х	Add "within seven working days of receipt" to the existing requirement for TAKE CHARGE providers to forward the client's medical ID card to them;
Х	Include language in the TAKE CHARGE section about "informing the client of their right to see any TAKE CHARGE provider within the state."
Х	Incorporate into rule current policy that abortions and other pregnancy-related services are not covered under the TAKE CHARGE program.
Х	Change the language under the TAKE CHARGE - good cause exemption section from TAKE CHARGE applicants who are either adolescents or young adults, to "eighteen years of age or younger" and change domestic violence victims to those "domestic violence victims who depend on their spouse's insurance...."
Х	Identify when TAKE CHARGE providers are exempt from billing third party [parties].

й Washington State Code Reviser's Office