HEALTH CARE AUTHORITY

[Filed September 1, 2020, 10:54 a.m., effective September 1, 2020, 10:54 a.m.]

Effective Date of Rule: Immediately upon filing.

Purpose: The health care authority (HCA) is establishing rules to comply with ESHB 1109, section 211(47), which provides funding for services identical to those services covered by the Washington state family planning waiver program to individuals who: (1) Are age twenty and older; (2) who are at or below two hundred sixty percent of the federal poverty level; (3) who are not covered by public or private insurance; and (4) who need family planning services and are not currently covered by or eligible for another medical assistance program for family planning.

Citation of Rules Affected by this Order: Amending WAC 182-535-510.

Statutory Authority for Adoption: RCW 41.05.021, 41.05.160; ESHB 1109, section 211(47), chapter 415, Laws of 2019, operating budget.

Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest; and 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: This emergency is necessary to continue the current emergency filed under WSR 20-10-020, which is set to expire September 3, 2020, while HCA completes the permanent rule-making process. This emergency implements the requirements in ESHB 1109, section 211(47), chapter 415. Since the last emergency filing, originally, HCA scheduled a public hearing for May 26, 2020, but this hearing was continued to a virtual public hearing on June 23, 2020, due to the governor's extended orders to Stay Home, Stay Safe. HCA is considering stakeholder comments.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.

Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.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 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: September 1, 2020.

AMENDATORY SECTION(Amending WSR 19-18-024, filed 8/28/19, effective 10/1/19)

WAC 182-532-510Family planning only programs—Eligibility.

To be eligible for one of the family planning only programs listed in this section, a client must meet the qualifications for that program.

(1) Family planning only - Pregnancy related program.

(a) To be eligible for family planning only - Pregnancy related services, as defined in WAC 182-532-001, a client must be determined eligible for the Washington apple health for pregnant ((clients))women program during the pregnancy, or determined eligible for a retroactive period covering the end of a pregnancy. See WAC 182-505-0115.

(b) A client is automatically eligible for the family planning only - Pregnancy related program when the client's pregnancy ends.

(c) A client may apply for the family planning only program in subsection (2) of this section up to sixty days before the expiration of the family planning only - Pregnancy related program.

(2) Family planning only program.

(a) To be eligible for family planning only services, as defined in WAC 182-532-001, a client must:

(i) ((Be a United States citizen, U.S. National, or "qualified alien" as described under WAC 182-503-0535;

(ii))) Provide a valid Social Security number (SSN), unless ineligible to receive one, or meet good cause criteria listed in WAC 182-503-0515(2);

(((iii)))(ii) Be a Washington state resident, as described under WAC 182-503-0520;

(((iv)))(iii) Have an income at or below two hundred sixty percent of the federal poverty level, as described under WAC 182-505-0100;

(((v)))(iv) Need family planning services; and

(((vi)))(v) Have been denied apple health coverage within the last thirty days, unless the applicant:

(A) Is age eighteen ((and))or younger and seeking services in confidence;

(B) Is a domestic violence victim who is seeking services in confidence; or

(C) Has an income of one hundred fifty percent to two hundred sixty percent of the federal poverty level, as described in WAC 182-505-0100.

(b) A client is not eligible for family planning only medical if the client is:

(i) Pregnant;

(ii) Sterilized;

(iii) Covered under another apple health program that includes family planning services; or

(iv) Covered by concurrent creditable coverage, as defined in RCW 48.66.020, unless they meet criteria in (a)(((vi)))(v) of this subsection.

(c) A client may reapply for coverage under the family planning only program up to sixty days before the expiration of the twelve-month coverage period. The agency does not limit the number of times a client may reapply for coverage.