WSR 18-17-047
PERMANENT RULES
HEALTH CARE AUTHORITY
[Filed August 8, 2018, 1:43 p.m., effective October 1, 2018]
Effective Date of Rule: October 1, 2018.
Purpose: The agency is creating rules to allow for enhanced rates for pediatric care services and the administration of vaccines provided to clients age eighteen and younger.
Citation of Rules Affected by this Order: New WAC 182-531-2030.
Statutory Authority for Adoption: RCW
41.05.021,
41.05.160, ESSB 6032, section 213 (1)(ddd).
Adopted under notice filed as WSR 18-14-082 on July 2, 2018.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 1, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 0.
Date Adopted: August 8, 2018.
Wendy Barcus
Rules Coordinator
NEW SECTION
WAC 182-531-2030Enhanced rates for pediatric care services and administration of vaccines.
(1) Subject to available funds, the agency pays an enhanced rate for covered pediatric care services and the administration of vaccines provided to clients age eighteen and younger.
(2) For the purposes of this section, pediatric care services are defined as covered evaluation and management services.
(3) The agency uses the resource-based relative value scale (RBRVS) payment methodology described in WAC 182-531-1850 to calculate the enhanced rate.
(4) If the enhanced rate is less than the agency's published fee schedule rate, the agency pays the published rate.
(5) This enhanced rate applies only to pediatric care services and administration of vaccines for clients age eighteen and younger that are not already paid at an enhanced rate.