WSR 22-07-097
EXPEDITED RULES
HEALTH CARE AUTHORITY
[Filed March 22, 2022, 1:06 p.m.]
Title of Rule and Other Identifying Information: WAC 182-512-0150 SSI-related medical—Medically needy (MN) medical eligibility.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Correct rule cross-reference.
Reasons Supporting Proposal: The agency is making housekeeping changes only. WAC 182-512-0150 contains incorrect rule cross-references in subsections (1)(e) and (6). In subsection (1)(e), the agency is editing the rule to replace an incorrect reference to WAC 182-513-1305 with the correct reference to WAC 182-513-1205. In subsection (6), the agency is replacing an incorrect reference to WAC 182-513-1305 with the correct reference to WAC 182-513-1395. This filing replaces a CR-105 filed as WSR 22-06-049 on February 24, 2022, and withdrawn by WSR 22-07-093 filed on March 22, 2022.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Health care authority (HCA), governmental.
Name of Agency Personnel Responsible for Drafting: Brian Jensen, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-0815; Implementation and Enforcement: Paige Lewis, P.O. Box 45534, Olympia, WA 98504-5534, 360-725-0757.
Agency Comments or Recommendations, if any, as to Statutory Language, Implementation, Enforcement, and Fiscal Matters: Not applicable.
This notice meets the following criteria to use the expedited adoption process for these rules:
Corrects typographical errors, make address or name changes, or clarify language of a rule without changing its effect.
Explanation of the Reason the Agency Believes the Expedited Rule-Making Process is Appropriate: Corrects cross-references to other rules.
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 Rules Coordinator, HCA, P.O. Box 42716, Olympia, WA 98504-2716, phone 360-725-1306, fax 360-586-9272, email arc@hca.wa.gov, AND RECEIVED BY May 24, 2022.
March 22, 2022
Wendy Barcus
Rules Coordinator
OTS-3643.2
AMENDATORY SECTION(Amending WSR 14-07-059, filed 3/14/14, effective 4/14/14)
WAC 182-512-0150SSI-related medical—Medically needy (MN) medical eligibility.
(1) Washington apple health (WAH) medically needy (MN) health care coverage is available for any of the following:
(a) A person who is SSI-related and not eligible for WAH categorically needy (CN) medical coverage because the person has countable income that is above the WAH CN income level (CNIL) (or for long-term care (LTC) recipients, above the special income limit (SIL)):
(i) The person's countable income is at or below WAH MN standards, leaving no spenddown requirement; or
(ii) The person's countable income is above WAH MN standards requiring the person to spenddown their excess income (see subsection (4) of this section). See WAC 182-512-0500 through 182-512-0800 for rules on determining countable income, and WAC 182-519-0050 for program standards or chapter 182-513 WAC for institutional standards.
(b) An SSI-related ineligible spouse of an SSI recipient;
(c) A person who meets SSI program criteria but is not eligible for the SSI cash grant due to immigration status or sponsor deeming. See WAC 182-503-0535 for limits on eligibility for aliens;
(d) A person who meets the WAH MN LTC services requirements of chapter 182-513 WAC;
(e) A person who lives in an alternate living facility and meets the requirements of WAC ((182-513-1305))182-513-1205; or
(f) A person who meets resource requirements as described in chapter 182-512 WAC, elects and is certified for hospice services per chapter 182-551 WAC.
(2) A person whose countable resources are above the SSI resource standards is not eligible for WAH MN noninstitutional health care coverage. See WAC 182-512-0200 through 182-512-0550 to determine countable resources.
(3) A person who qualifies for services under WAH long-term care programs has different criteria and may spend down excess resources to become eligible for WAH LTC institutional or waiver health care coverage. Refer to WAC 182-513-1315 and 182-513-1395.
(4) A person with income over the effective WAH MN income limit (MNIL) described in WAC 182-519-0050 may become eligible for WAH MN coverage when the person has incurred medical expenses that are equal to the excess income. This is the process of meeting spenddown. Refer to chapter 182-519 WAC for spenddown information.
(5) A person may be eligible for health care coverage for any or all of the three months immediately prior to the month of application, if the person has:
(a) Met all eligibility requirements for the months being considered; and
(b) Received medical services covered by medicaid during that time.
(6) A person who is eligible for WAH MN without a spenddown is certified for up to ((twelve))12 months. For a person who must meet a spenddown, refer to WAC 182-519-0110. For a person who is eligible for a WAH long-term care MN program, refer to WAC ((182-513-1305))182-513-1395 and 182-513-1315.
(7) A person must reapply for each certification period. There is no continuous eligibility for WAH MN.