WSR 08-18-048

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed August 29, 2008, 11:19 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 08-06-044.

Title of Rule and Other Identifying Information: The department is amending WAC 388-416-0020 Certification periods for noninstitutionalized medically needy (MN) program.

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) 664-6094), on October 7, 2008, at 10:00 a.m.

Date of Intended Adoption: Not earlier than October 8, 2008.

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 DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on October 7, 2008.

Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by September 30, 2008, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at johnsjl4@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: DSHS is removing references to hospital expenses to comply with federal regulations.

Reasons Supporting Proposal: Being compliant with federal regulation prevents jeopardizing federal financial participation in the state's medicaid program.

Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.500.

Statute Being Implemented: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.500.

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, Implementation and Enforcement: Catherine Fisher, P.O. Box 45534, Olympia, WA 98504-5534, (360) 725-1357.

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

A cost-benefit analysis is not required under RCW 34.05.328. Client eligibility rules for medical assistance are exempt from the cost-benefit analysis requirement per RCW 34.05.328 (5)[(b)](vii).

August 22, 2008

Stephanie E. Schiller

Rules Coordinator

4019.1
AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-416-0020   Certification periods for the noninstitutional((ized)) medically needy (MN) program.   (1) The certification period for the noninstitutional((ized)) medically needy (MN) program ((begins)) for clients with countable income equal to or below the medically needy income level (MNIL):

(a) Begins on the first day of the month in which ((hospital expenses equal the spenddown amount)) eligibility is established; ((or)) and

(b) ((On the day that spenddown is met, when hospital expenses are less then the spenddown amount or no hospital expenses are involved)) Is approved for twelve calendar months.

(2) The certification period ((continues through the last day of the final month of the base period as described in chapter 388-519 WAC)) for the noninstitutional MN program for clients with countable income above the MNIL:

(a) Begins on the day that spenddown is met; and

(b) Continues through the last day of the final month of the base period as described in WAC 388-519-0110.

(3) ((The)) A retroactive MN certification period ((can begin up to)) may be established for any or all of the three months immediately prior to the month of application ((as described in chapter 388-519 WAC)).

(4) ((The certification period for MN clients with income below the medically needy income level (MNIL) is twelve months)) Expenses used to meet the spenddown liability for the current or the retroactive certification periods are the responsibility of the client. The department is not responsible to pay for any expense or portion of an expense which has been used to meet the spenddown liability. See WAC 388-519-0110.

(5) A new application must be submitted for each subsequent certification period for which medically needy coverage is requested.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-416-0020, filed 7/31/98, effective 9/1/98. Formerly WAC 388-521-2105 and 388-521-2130.]

Washington State Code Reviser's Office