WSR 15-17-056 PERMANENT RULES HEALTH CARE AUTHORITY (Washington Apple Health) [Filed August 14, 2015, 9:22 a.m., effective September 14, 2015] Effective Date of Rule: Thirty-one days after filing.
Purpose: This rule amendment clarifies eligibility for the breast and cervical cancer treatment program.
Citation of Existing Rules Affected by this Order: Amending WAC 182-505-0120.
Statutory Authority for Adoption: RCW 41.05.021, 41.05.160.
Adopted under notice filed as WSR 15-12-076 on May 29, 2015.
Changes Other than Editing from Proposed to Adopted Version: The agency removed the reference to alternative benefit plan in subsection (1)(d) and clarified that Washington apple health-categorically needy includes the modified adjusted gross income-based adult group.
Also, subsection (1)(i) includes an editorial change that lists the department of health's (DOH) form number for income standards and replaces a reference to DOH's web site.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: August 14, 2015.
Wendy Barcus
Rules Coordinator
AMENDATORY SECTION (Amending WSR 14-21-075, filed 10/10/14, effective 11/10/14)
WAC 182-505-0120 Washington apple health breast and cervical cancer treatment program (((BCCTP))) for women—Client eligibility.
(1) Effective April 1, 2014, a woman is eligible for categorically needy (CN) coverage under the Washington apple health (WAH) breast and cervical cancer treatment program (BCCTP) only when she:
(a) Has been screened for breast or cervical cancer under the department of health's breast, cervical, and colon health program (BCCHP);
(b) ((Is found to)) Requires treatment for ((either)) breast ((or)) cancer, cervical cancer, or ((for)) a related precancerous condition;
(c) Is under sixty-five years of age;
(d) Is not ((covered by another WAH-CN program)) eligible for other WAH-CN coverage, including coverage under the MAGI-based adult group;
(e) Is uninsured or does not otherwise have creditable coverage;
(f) Meets residency requirements ((as described in)) under WAC 182-503-0520;
(g) Meets Social Security number requirements ((as described in)) under WAC 182-503-0515;
(h) ((Meets the requirements for citizenship or U.S. national status)) Is a U.S. citizen, U.S. national, qualifying American Indian born abroad, or (("))qualified alien((" status as described in)) under WAC 182-503-0535; and
(i) Meets the income standard set by the BCCHP (((the standard may be found at: http://www.doh.wa.gov/Portals/1/Documents/Pubs/342-090-BCCHPFundingSources.pdf))) in DOH form 342-031.
(2) The certification period for breast and cervical cancer treatment covered under this section is twelve months, as provided in WAC 182-504-0015. ((Renewal of eligibility must be completed prior to the end of each certification period)) To remain continuously enrolled, the client must renew her eligibility before the certification period ends. Eligibility for BCCTP coverage under subsection (1)(b) of this section continues throughout the course of treatment as certified by the BCCHP. Retroactive coverage ((is)) may be available ((as provided in)) under WAC 182-504-0005.
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