WSR 16-10-039 EMERGENCY RULES HEALTH CARE AUTHORITY (Washington Apple Health) [Filed April 28, 2016, 9:30 a.m., effective April 28, 2016, 9:30 a.m.] Effective Date of Rule: Immediately upon filing.
Purpose: The agency is amending this rule to specify that subsection (3) of WAC 182-506-0010 applies only to children age eighteen and younger.
Citation of Existing Rules Affected by this Order: Amending WAC 182-506-0010.
Under RCW 34.05.350 the agency for good cause finds that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.
Reasons for this Finding: As written, WAC 182-506-0010 does not comply with 42 C.F.R. 435.603(f).
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.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: April 28, 2016.
Wendy Barcus
Rules Coordinator
AMENDATORY SECTION (Amending WSR 16-07-006, filed 3/3/16, effective 4/3/16)
WAC 182-506-0010 Medical assistance units for MAGI-based programs.
This section applies to applicants or recipients whose financial eligibility for Washington apple health coverage is based on modified adjusted gross income methodology under WAC 182-503-0510 and 182-509-0300.
(1) General medical assistance unit (MAU) rules.
(a) The rules in this section describe how the medicaid agency must determine who is in an applicant's or recipient's MAU.
(b) Each person will have an individualized MAU and may have different eligibility results than other people on the same application.
(c) The countable income used to determine a person's eligibility is the sum of the countable income of everyone in the person's MAU.
(2) Rules regardless of tax filing status.
(a) If a married couple resides together, the agency must include both people in each other's MAU regardless of tax filing status.
(b) If a member of the MAU is pregnant, the number of people in the MAU increases by one for each unborn child.
(c) A deceased person does not count in the MAU of other applicants or recipients except in the month the person died.
(3) ((People)) Children residing in an institution under chapter 182-514 WAC. An applicant or recipient is the only person in the MAU if the applicant or recipient is a child age eighteen and younger and:
(a) Has resided in a medical institution, institution for mental diseases (IMD), or inpatient psychiatric facility for thirty consecutive days; or
(b) Based on an assessment by the department of social and health services, is likely to reside in a medical institution, IMD, or inpatient psychiatric facility for thirty consecutive days.
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