WSR 15-09-059 EXPEDITED RULES HEALTH CARE AUTHORITY (Washington Apple Health) [Filed April 14, 2015, 10:00 a.m.]
Title of Rule and Other Identifying Information: WAC 182-504-0005 Washington apple health—Retroactive certification period.
NOTICE
THIS RULE IS BEING PROPOSED UNDER AN EXPEDITED RULE-MAKING PROCESS THAT WILL ELIMINATE THE NEED FOR THE AGENCY TO HOLD PUBLIC HEARINGS, PREPARE A SMALL BUSINESS ECONOMIC IMPACT STATEMENT, OR PROVIDE RESPONSES TO THE CRITERIA FOR A SIGNIFICANT LEGISLATIVE RULE. IF YOU OBJECT TO THIS USE OF THE EXPEDITED RULE-MAKING PROCESS, YOU MUST EXPRESS YOUR OBJECTIONS IN WRITING AND THEY MUST BE SENT TO Jason R. P. Crabbe, Rules Coordinator, Health Care Authority, P.O. Box 42716, Olympia, WA 98504-2716, or deliver to Cherry Street Plaza, 626 8th Avenue S.E., Olympia, WA 98504, e-mail arc@hca.wa.gov, fax (360) 586-9727, AND RECEIVED BY June 22, 2015.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The agency is amending the rule to fix an incorrect citation.
Reasons Supporting Proposal: See Purpose above.
Statutory Authority for Adoption: RCW 41.05.021, 41.05.160.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Health care authority, governmental.
Name of Agency Personnel Responsible for Drafting: Sean Sullivan, P.O. Box 42716, Olympia, WA 98504-2716, (360) 725-1344; Implementation and Enforcement: Mick Pettersen, P.O. Box 45534, Olympia, WA 98504-5534, (360) 725-0913.
April 14, 2015
Jason R. P. Crabbe
Rules Coordinator
AMENDATORY SECTION (Amending WSR 13-14-019, filed 6/24/13, effective 7/25/13)
WAC 182-504-0005 Washington apple health—Retroactive certification period.
(1) The medicaid agency approves a retroactive Washington apple health (WAH) certification period for the three months immediately before the month of application when an individual:
(a) Requests retroactive WAH on ((his or her)) the application, within the certification period following the retroactive period, or before the determination of benefits and any appeal process is final;
(b) Would have been eligible for WAH for any or all of the three months if ((he or she)) the individual had applied during the retroactive period; and
(c) The individual received covered medical services as described in WAC 182-501-0060 and 182-501-0065.
(2) When an individual is eligible only during the three-month retroactive certification period, that period is the only period of certification, except when:
(a) A pregnant woman is eligible in one of the three months immediately before the month of application, but no earlier than the month of conception. Eligibility continues as described in WAC 182-504-0015(3).
(b) A child is eligible for categorically needy (CN) WAH as described in WAC 182-505-0210 (1) through (5) and (7) in at least one of the three months immediately before the month of application. Eligibility after the retroactive period continues as described in WAC 182-504-0015(((11))) (9).
(3) An individual applying for the medically needy (MN) spenddown program may be eligible for a retroactive certification period as described in WAC 182-504-0020.
(4) An individual applying for a medicare savings program may be eligible for a retroactive certification period as described in WAC 182-504-0025.
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