WSR 08-23-099

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed November 19, 2008, 11:20 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 08-20-088.

Title of Rule and Other Identifying Information: The department is amending 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 http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6094), on December 23, 2008, at 10:00 a.m.

Date of Intended Adoption: Not sooner than December 24, 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 December 23, 2008.

Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by December 9, 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 updating the citizenship exemptions based on modifications to the Deficit Reduction Act (DRA) final rule and changes to Section 405 (c)(1) of the Tax Relief and Health Care Act of 2006 (TRHCA).

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

Statutory Authority for Adoption: RCW 74.04.057, 74.08.090, and 74.09.530.

Statute Being Implemented: RCW 74.04.057, 74.08.090, and 74.09.530.

Rule is necessary because of federal law, Federal Tax Relief & Healthcare Act of 2006; Federal Deficit Reduction Act of 2005.

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

Name of Agency Personnel Responsible for Drafting: Kathy Sayre, P.O. Box 45504, Olympia, WA 98504-5504, (360) 725-1342; Implementation and Enforcement: Kathy Johansen, P.O. Box 45534, Olympia, WA 98504-5534, (360) 725-1321.

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).

November 12, 2008

Stephanie E. Schiller

Rules Coordinator

4040.1
AMENDATORY SECTION(Amending WSR 07-02-066, filed 12/29/06, effective 1/29/07)

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) Title IV-B child welfare services, or Title IV-E adoption assistance or foster care payments;

(b) SSI ((cash)) benefits; ((or))

(((b))) (c) Social security benefits (based on their own disability); or

(d) Medicare.

[Statutory Authority: RCW 74.04.057, 74.08.090, 74.09.530, and Public Law 109-171, Section 6036. 07-02-066, 388-490-0005, filed 12/29/06, effective 1/29/07. 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