WSR 24-13-126
AGENDA
HEALTH CARE AUTHORITY
[Filed June 20, 2024, 10:43 a.m.]
The Washington health care authority (HCA) prepares a semi-annual rule-making agenda in January and July each year for publication in the Washington State Register pursuant to RCW 34.05.314. This report details current and anticipated rule-making activities for HCA. Additional rule-making activity may occur which is not listed on this agenda as conditions warrant.
Rule-making information is available on HCA's website https://www.hca.wa.gov/about-hca/rulemaking.
To be notified of any changes, you may sign up for email notifications https://public.govdelivery.com/accounts/WAHCA/subscriber/new?qsp=WAHCA_10.
If you have questions about this rule-making agenda, contact Wendy Barcus, Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, phone 360-725-1306, email wendy.barcus@hca.wa.gov.
Semi-Annual Rule-Making Agenda
July - December 2024
WAC Chapter
Rule Subject
Current Activity
Preproposal Notice
CR-101
Proposed Rule
CR-102
(Public Hearing) or
CR-105 (Expedited)
Emergency
CR-103E
HEALTH CARE AUTHORITY - GENERAL
182-50-030
Prescription drug programsPeriod of appointment
WSR 24-10-017
Filed 4/19/2024
CR-102
WSR 24-13-041
Public hearing scheduled for 7/25/2024
 
New chapter
182-80
Primary care transformation model (PCTM)Provider certification
WSR 23-01-066
Filed 12/14/2022
Withdrawn
WSR 23-06-071
Filed 3/1/2023
 
 
PUBLIC EMPLOYEE BENEFITS BOARD (PEBB)
Chapters 182-08,
182-12, and 182-16
PEBBGeneral updates and PEBB resolutions
WSR 24-04-060
Filed 2/1/2024
WSR 24-04-061
Filed 2/1/2024
To be filed soon
 
182-12-5100
What options for health plan enrollment are available to a retired employee of an employer group that previously ended participation in PEBB insurance coverage, as authorized in SSB 1804, section 3, chapter 312, Laws of 2023
WSR 24-04-060
Filed 2/1/2024
These rules are being incorporated into the main PEBB rule making
WSR 24-12-022
Effective 5/24/2024
182-12-5110,
182-12-5120
When is a retiring school employee of an employer group eligible to enroll in PEBB retiree insurance coverage; and What options for continuing health plan enrollment are available to a retiree of an employer group that ends participation in PEBB or SEBB insurance coverage, as authorized in SHB 1804, section 1, chapter 312, Laws of 2023
WSR 24-04-060
Filed 2/1/2024
These rules are being incorporated into the main PEBB rule making
WSR 24-11-151
Filed 5/22/2024
182-12-5200
When is a retiring employee or a retiring school employee who separates from employment eligible to enroll in PEBB retiree insurance coverage, as authorized in HB 1008, chapter 164, Laws of 2023
WSR 24-04-060
Filed 2/1/2024
These rules are being incorporated into the main PEBB rule making
WSR 24-10-057
Filed 4/26/2024
SCHOOL EMPLOYEE BENEFITS BOARD (SEBB)
Chapters 182-30,
182-31, and 182-32
SEBBAnnual updates
WSR 24-04-062
Filed 2/1/2024
CR-102
WSR 24-11-094
Public hearing schedule for 6/25/2024
WSR 24-06-011
Effective 2/23/2024
182-31-070
SEBBIs dual enrollment in SEBB and PEBB prohibited?
WSR 24-04-064
Filed 2/1/2024
CR-102
WSR 24-11-095
Public hearing scheduled for 6/25/2024
 
182-31-080
SEBBWhen may a school employee waive enrollment in SEBB medical and when may they enroll in SEBB medical after having waived enrollment?
WSR 24-04-064
Filed 2/1/2024
CR-102
WSR 24-11-097
Public hearing scheduled for 6/25/2024
 
182-31-090
SEBBWhen is an enrollee eligible to continue SEBB benefits under COBRA
WSR 24-04-064
Filed 2/1/2024
CR-102
WSR 24-11-098
Public hearing scheduled for 6/25/2024
 
182-31-130
SEBBWhat options for continuation coverage are available to dependents to cease to meet the eligibility criteria as described in WAC 182-31-140 or 182-30-130
WSR 24-04-064
Filed 2/1/2024
CR-102
WSR 24-11-099
Public hearing scheduled for 6/25/2024
 
182-30-100
SEBBWhen may a school employee enroll, or revoke an election and make a new election under the premium payment plan, medical flexible spending arrangement (FSA), limited purpose FSA, or dependent care assistance program (SCAP)
WSR 24-04-064
Filed 2/1/2024
CR-102
WSR 24-11-100
Public hearing scheduled for 6/25/2024
 
182-30-5000, 182-30-5010
SEBB employer groups, as authorized in SSB 5275, chapter 13, Laws of 2023
 
These rules are being incorporated into the main SEBB rule making
WSR 24-06-011
Effective 2/23/2024
WASHINGTON BEHAVIORAL HEALTH
182-115-0100,
182-502-0002
Certified peer counselorGeneral; Eligible provider types
HCA intends to begin rule making soon to implement SB [2SSB] 5555
 
 
182-115-0200
Certified peer counselorApplication, training, examination, and authority approval
HCA intends to begin rule making soon to implement SB [2SSB] 5555
 
 
182-140
Mobile rapid response crisis team endorsement
WSR 24-05-041
Filed 2/14/2024
 
 
WASHINGTON APPLE HEALTH
182-502-0005,
182-502-0006,
182-502-0010,
182-502-0012,
182-502-0030,
182-502-0040,
182-502-0050,
182-502-0100
Core provider agreement (CPA); Enrollment for nonbilling individual providers; When the medicaid agency enrolls; When the medicaid agency does not enroll; Termination of a provider agreementFor cause; Termination of a provider agreementFor convenience
HCA intends to begin rule making soon
 
WSR 24-11-036
Effective 5/8/2024
182-505-0100,
182-509-0305
Monthly income standards for MAGI-based programs; MAGI incomePersons subject to the MAGI methodology
WSR 24-13-063
Filed 6/13/2024
 
 
182-507-0125
State-funded long-term care services
WSR 24-08-055
Filed 3/29/2024
CR-102
WSR 24-13-044
Public hearing scheduled for 7/25/2024
 
182-508-0200
Civil transition program (CTP)
WSR 24-06-021
Filed 2/28/2024
CR-102
WSR 24-11-065
Public hearing scheduled for 6/25/2024
WSR 24-08-051
Effective 3/29/2024
182-512-0600,
182-512-0650,
182-512-0800
Supplemental security income (SSI) removing barriers to accessing SSI payments
WSR 24-12-052
Filed 5/31/2024
 
 
182-513-1530
Maximum guardianship fee
WSR 24-10-036
Filed 4/23/2024
CR-102
WSR 24-13-077
Public hearing scheduled for 7/25/2024
 
New chapters:
182-525, 182-525A, and 182-525B;
Revisions to:
182-500-120,
182-501-0060,
182-503-0510,
182-503-1515,
182-509-0220,
182-526-0005
Apple health expansion
WSR 23-14-063
Filed 6/28/2023
 
WSR 24-13-067
Effective 6/17/2024
182-530-7150,
182-530-8150
ReimbursementCompounded prescriptions; ReimbursementAutomated maximum allowable cost (AMAC)
WSR 24-11-004
Filed 5/2/2024
 
 
182-531-1250,
182-531-1350
Physician standby and prolonged services
HCA intends to begin rule making soon
 
 
182-531-1675
Gender affirming interventions for gender dysphoria
WSR 24-08-052
Filed 3/29/2024
 
 
New rules in chapter 182-531
Community health worker
HCA intends to begin rule making soon
 
 
182-532-001,
182-532-510
Reproductive health servicesDefinitions; Family planning only programEligibility
WSR 23-16-017
Filed 7/20/2023
 
 
182-532-530,
182-532-550,
182-532-560
Family planning only programsCovered services, payment limitations, and documentation requirements
WSR 23-24-065
Filed 12/04/2023
 
WSR 24-10-058
Effective 4/26/2024
182-533, 182-502-0002
Maternity related servicesBirth doula services; Eligible provider typesAdding birth doula
WSR 24-10-016
Filed 4/19/2024
 
 
182-538-110
Managed careThe grievance and appeal system and agency administrative hearing for managed care organization (MCO) enrollees
HCA intends to begin rule making soon.
 
 
182-543-1000
Medical supplies and equipmentDefinitions
WSR 24-09-006
Filed 4/4/2024
 
 
182-543-3000,
182-543-7000
CoveredHospital beds, mattresses, and related equipment
WSR 24-07-007
Filed 3/7/2024
 
 
182-543-3300
CoveredOsteogenesis electrical stimulator (bone growth stimulator)
WSR 24-10-047
Filed 4/24/2024
 
 
182-545-200
Outpatient rehabilitation (occupational therapy, physical therapy, and speech therapy) for behavioral health
WSR 24-08-056
Filed 3/29/2024
CR-102
WSR 24-11-135
Public hearing scheduled for 6/25/2024
 
182-546-4700
Ambulance transportationAmbulance transport fund
WSR 24-11-079
Filed 5/15/2024
 
 
182-548-1300,
182-549-1300
Rural health clinics; Federally-qualified health centersAdding substance use disorder professionals (SUDP)
HCA intends to begin rule making soon
 
 
182-550-1500
Covered and noncovered revenue code categories and subcategories for outpatient hospital services
WSR 24-08-065
Filed 4/1/2024
CR-102
WSR 24-11-146
Public hearing scheduled for 6/25/2024
 
182-550-1900,
182-550-2100, 182-550-2200
Transplant coverage and requirements
HCA intends to begin rule making soon
 
 
182-550-3800
Rebasing
WSR 24-11-115
Filed 5/20/2024
 
 
182-550-3830,
182-550-7550
Adjustment to inpatient rates and OPPS payment enhancement
WSR 24-11-132
Filed 5/21/2024
 
 
182-550-4400
ServicesExempt from DRG payment
WSR 24-11-110
Filed 5/20/2024
 
 
182-551
Alternative to hospital servicesMedical respite program
WSR 24-05-081
Filed 2/21/2024
 
 
182-553
182-551-2000,
182-551-2010,
182-551-2100,
182-551-2130
Home infusion therapy/parenteral nutrition program and home health services
HCA intends to begin rule making soon
 
 
182-551-2230
Electronic visit verification (EVV)System requirements
WSR 24-05-023
Filed 2/12/2024
 
 
182-556-0200,
182-556-0250 (new),
182-501-0070,
182-502-0002,
182-502-0003,
182-531-0050
Acupuncture services and chiropractic servicesAdding coverage for acupuncture and chiropractic services for adults
WSR 24-13-055
Filed 6/13/2024
 
 
182-557-0200
Health home eligibility
WSR 23-23-182
Filed 11/22/2023
 
 
182-561-0600
Service tiers
HCA intends to begin rule making soon to fix an error in the tiers
 
 
KEY:
CR: "Code Reviser" on the rule-making forms produced by the office of the code reviser.
CR-101: Preproposal statement of inquiry filed under RCW 34.05.310.
CR-102: Proposed rule-making notice filed under RCW 34.05.320 or 34.05.340.
CR-103: Rule-making order permanently adopting a rule, and filed under RCW 34.05.360 and 34.05.380.
CR-105: Expedited rule-making proposal filed under RCW 34.05.353.
RCW: Revised Code of Washington.
WAC: Washington Administrative Code.
WSR: Washington State Register official filing reference number given by the office of the code reviser when a notice is filed.
Wendy Barcus
Rules Coordinator