WSR 10-13-129



(Medicaid Purchasing Administration)

[ Filed June 22, 2010, 2:52 p.m. ]

Subject of Possible Rule Making: WAC 388-416-0015 Certification periods for categorically needy (CN) scope of care medical assistance programs, 388-450-0215 How does the department estimate my income to determine my eligibility and benefits?, 388-505-0210 Apple health for kids programs, 388-505-0211 Premium requirements for premium-based healthcare coverage under apple health for kids, and 388-542-0020 Other rules that apply to premium-based healthcare coverage under apple health for kids.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 74.04.050, 74.04.057, and 74.08.090; Apple Health for Kids Act (ESHB 2128); 42 U.S.C. 1305; Public Law 111-3 (Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009).

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The recent passage of the federal CHIPRA of 2009 requires the department to amend its rules regarding newborn eligibility for medical assistance. Per clarification from the federal Centers for Medicare and Medicaid Services (CMS), CHIPRA also requires the elimination of the three-month sanction for nonpayment of the children's health insurance program (CHIP) premium, and allow for medical coverage to be reinstated for all months within the certification period when payment of the delinquent premium is made prior to the end of the certification period. This change to Washington's CHIP program will meet "continuous eligibility" as an enrollment and retention strategy as defined in CHIPRA, which will qualify Washington for the performance bonus described in CHIPRA, section 104. Recently enacted state law (ESHB 2128) changed the name of children's healthcare programs to apple health for kids.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.

Process for Developing New Rule: DSHS welcomes the public to take part in developing the rules. Anyone interested should contact the staff person identified below. At a later date, DSHS will file a proposal with the office of the code reviser with a notice of proposed rule making. A copy of the proposal will be sent to everyone on the mailing list and to anyone who requests a copy.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kevin Sullivan, P.O. Box 45504, Olympia, WA 98504-5504, phone (360) 725-1344, fax (360) 586-9727, TTY 1-800-848-5429, e-mail

June 22, 2010

Katherine I. Vasquez

Rules Coordinator

Washington State Code Reviser's Office