PREPROPOSAL STATEMENT OF INQUIRY
(Medicaid Program)
Subject of Possible Rule Making: WAC 182-543-9100 Reimbursement method -- Other DME, 182-543-9200 Reimbursement method -- Wheelchairs, 182-543-9300 Reimbursement method -- Prosthetics and orthotics, 182-543-9400 Reimbursement method -- Medical supplies and related services, 182-553-500 Home infusion therapy/parenteral nutrition program -- Coverage, services, limitations, prior authorization, and reimbursement, and other related rules as appropriate.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 41.05.021.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: To achieve targeted durable medical equipment (DME) savings directed by the legislature in the budget for 2011-13, the agency is reducing rates for medical equipment and supplies for DME-medical supplies and equipment, DME-other DME, DME-wheelchairs and accessories, enteral nutrition, home infusion therapy/parenteral nutrition, respiratory care (oxygen), and prosthetics and orthotics. The agency is opening the necessary sections in order for the permanent changes to be made to the reimbursement methodologies. During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy.
Process for Developing New Rule: The health care authority (HCA) welcomes the public to take part in developing the rules. Anyone interested should contact the staff person identified below. At a later date, HCA will file a notice of proposed rule making (CR-102) with the office of the code reviser. 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 Wendy L. Boedigheimer, Rule Program Manager, P.O. Box 45504, Olympia, WA 98504-5504, fax (360) 586-9727, TTY 1-800-848-5429, e-mail wendy.boedigheimer@hca.wa.gov.
April 20, 2012
Kevin M. Sullivan
Rules Coordinator