WSR 97-08-030
EMERGENCY RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Public Assistance)
[Filed March 27, 1997, 10:54 a.m.]
Date of Adoption: March 27, 1997.
Purpose: Provide for longer time frames for Medicaid to continue upon termination of SSI for persons impacted by federal revisions to the definition of disability and eligibility requirements of noncitizens.
Citation of Existing Rules Affected by this Order: Amending WAC 388-522-2205 and 388-524-2405.
Statutory Authority for Adoption: RCW 74.08.090 and 74.09.530.
Other Authority: 42 CFR 435.1003; 42 CFR Part 435; (MB-105-FC).
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: The federal regulation was implemented January 13, 1997.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, amended 2, repealed 0; Federal Rules or Standards: New 0, amended 0, repealed 0; or Recently Enacted State Statutes: New 0, amended 0, repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, amended 0, repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, amended 0, repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, amended 0, repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, amended 0, repealed 0; Pilot Rule Making: New 0, amended 0, repealed 0; or Other Alternative Rule Making: New 0, amended 2, repealed 0.
Effective Date of Rule: Immediately.
March 27, 1997
Merry A. Kogut, Manager
Rules and Policies Assistance Unit
AMENDATORY SECTION (Amending Order 3732, filed 5/3/94, effective 6/3/94)
WAC 388-522-2205 Redetermination of medical assistance. (1) Before termination of a client's medical assistance, the department shall redetermine the client's eligibility for other medical assistance programs or the medically indigent program.
(a) When additional information is necessary to redetermine eligibility, the department shall give the client ten days notice and an opportunity to provide such information.
(b) The department shall give the client advance and adequate notice of the redetermination decision before termination of medical assistance as described under WAC 388-245-1700.
(c) Until the department redetermines a client's eligibility in conformity with the requirements of this section, the client shall remain eligible for categorically needy medical benefits.
(2) ((The department shall redetermine the client's eligibility for
other financial and medical programs within thirty calendar days)) When
SSA terminates the client's SSI/SSP financial benefits, refer to WAC 388-524-2405.
[Statutory Authority: RCW 74.08.090. 94-10-065 (Order 3732), 388-522-2205, filed 5/3/94, effective 6/3/94. Formerly parts of WAC 388-85-105
and 388-85-110.]
AMENDATORY SECTION (Amending Order 3732, filed 5/3/94, effective 6/3/94)
WAC 388-524-2405 SSI/state supplement termination. ((When SSA
terminates an SSI/state supplemental client because of failure to meet
blindness and disability criteria under Title XVI,)) (1) The department
shall ((terminate)) provide uninterrupted medical assistance ((at the end
of the second month following the month in which eligibility based on
disability or blindness criteria ceases)) for a period of up to one
hundred twenty days:
(a) For a person whose SSI/state supplemental is terminated; and
(b) While the department redetermines the person's eligibility for other financial or medical programs.
(((1) If the client has)) (2) The department shall continue medical
assistance for a person:
(a) Who has filed a timely request for a hearing under SSA
jurisdiction; and ((SSA continues benefits, the department shall continue
medical assistance concurrently))
(b) Until SSA makes a final decision on the hearing request and any subsequent timely appeals.
(((2))) (3) The department shall not ((authorize the CSO to
re))submit a request for a redetermination of blindness or disability
((for consideration of the categorically needy or medically needy
program.
(3) If the client)) unless:
(a) The person presents new medical evidence ((to the CSO or the
client's));
(b) The person's medical condition worsens((, the department shall
require a referral to SSA)); or
(c) The termination of SSI/state supplement or Social Security
Disability Insurance was not based on a review of current medical
evidence.
[Statutory Authority: RCW 74.08.090. 94-10-065 (Order 3732), 388-524-2405, filed 5/3/94, effective 6/3/94. Formerly WAC 388-85-110 (part).]