PDFWAC 246-710-050

Authorization of diagnostic and treatment (DX/TX) funds.

The department may authorize diagnostic and treatment services paid for with CYSHCN funds in accordance with the following:
(1) The department shall make decisions about using DX/TX funds on a case-by-case basis. DX/TX funds are not intended for those items that are part of usual daily living expenses that are the responsibility of parents/caregivers. DX/TX funds are not entitlement funds and the local CYSHCN agency or the department may choose not to use those funds.
(2) The department may only make a decision about whether to pay for services with DX/TX funds once all of the following have been completed:
(a) Determination of financial eligibility for a client;
(b) Department receipt, review, and approval of a HSA form submitted electronically to the department by the local CYSHCN agency;
(c) Services must be recognized as an acceptable form of treatment by a significant portion of the professional community; and
(d) Determination by the department that the services are medically necessary.
(3) The department will not authorize payment for services for out-of-state providers if an equivalent service is available within the state of Washington. If an equivalent service is not available in Washington state, services for out-of-state providers may be approved by the department on a case-by-case basis.
(4) For the purposes of this section, "Health Services Authorization form" or "HSA form" means an electronic form which must be completed by the local CYSHCN agency and submitted to the department for approval or denial in order to access DX/TX funds to pay for service, treatment, or equipment.
[Statutory Authority: RCW 43.70.040, 43.70.080, and 43.70.120. WSR 20-16-108, § 246-710-050, filed 7/31/20, effective 8/31/20. Statutory Authority: RCW 43.20.140. WSR 99-01-100, § 246-710-050, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-050, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-060, filed 12/2/82.]