WSR 23-03-064
PERMANENT RULES
HEALTH CARE AUTHORITY
[Filed January 12, 2023, 8:22 a.m., effective February 12, 2023]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The agency is amending WAC 182-508-0005 to include individuals residing in "public institutions" (as that term is defined in WAC 182-500-0050) within the population not eligible for state-funded Washington apple health medical care services. The amendment is necessary to ensure that individuals residing in public institutions receiving a new aged, blind, or disabled program cash grant (ESSB 5693 section 205(22), chapter 297, Laws of 2022) do not thereby become eligible for state-funded Washington apple health medical care services.
Citation of Rules Affected by this Order: Amending WAC 182-508-0005.
Other Authority: ESSB 5693, section 205(22), chapter 297, Laws of 2022.
Adopted under notice filed as WSR 22-24-072 on December 5, 2022.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.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: January 12, 2023.
Wendy Barcus
Rules Coordinator
OTS-4185.1
AMENDATORY SECTION(Amending WSR 22-02-034, filed 12/29/21, effective 2/1/22)
WAC 182-508-0005Washington apple health medical care services—Eligibility and scope of coverage.
(1) A person is eligible for state-funded Washington apple health medical care services (MCS) coverage to the extent of available funds if the person is:
(a) Determined by the department of social and health services to be eligible for benefits under:
(i) The aged, blind, or disabled program as described in WAC 388-400-0060;
(ii) The housing and essential needs referral program as described in WAC 388-400-0070; or
(iii) The survivors of certain crimes (SCC) program, as described in WAC 388-424-0035, which includes victims of human trafficking as described in RCW
74.04.005; ((
and))
(b) Not eligible for another federally funded categorically needy (CN) (as defined in WAC 182-500-0020) or alternative benefits plan (ABP) (as defined in WAC 182-500-0010) Washington apple health program; and
(c) Not residing in a public institution as defined in WAC 182-500-0050.
(2) If an enrollment cap exists under WAC 182-508-0150, a waiting list of people may be established.
(3) A person's period of eligibility for MCS is the same as the person's period of eligibility for:
(a) The aged, blind, or disabled program as described in WAC 388-449-0150;
(b) The person's incapacity authorization period for the housing and essential needs referral program as described in WAC 388-447-0110; or
(c) The person's period of eligibility for the SCC program as described in WAC 388-424-0035.
(4) The MCS program covers only the medically necessary services defined in WAC 182-501-0060.
(5) The MCS program does not cover medical services received outside the state of Washington unless the medical services are provided in a border city listed in WAC 182-501-0175.