WSR 98-23-092

PREPROPOSAL STATEMENT OF INQUIRY

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

(Medical Assistance Administration)

[Filed November 18, 1998, 10:47 a.m.]

Subject of Possible Rule Making: WAC 388-86-112, 388-550-2300, and related sections: Physical medicine and rehabilitation (PM&R) is a twenty-four-hour comprehensive inpatient program of integrated medical and rehabilitation services which require prior authorization by the Medical Assistance Administration (MAA). A multidisciplinary team at an MAA approved rehabilitation facility coordinates individualized services. PM&R is designed for the client to achieve improved health and welfare with maximum physical, social, psychological, and vocational potential to return to the community.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 74.08.090, 74.09.520, and 42 CFR 482.56.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: These rules specify what inpatient rehabilitation services are available from MAA for eligible clients. The rule lets providers know the qualifications for becoming a contracted PM&R provider and what is included in each level of rehabilitation covered by MAA. It show providers the limitations of the program(s), that they must comply with these rules in order to receive payment, and that the benefits are limited to the acute phase of rehabilitation for clients.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: Medicare/HCFA - MAA uses the Medicare rehabilitation guidelines as a guide to running the PM&R program(s). The Department of Health (DOH) WAC 246-976-840, Designation standards for facilities providing level II trauma rehabilitation service. MAA coordinates with DOH; their rules contain the CARF standards required by MAA's PM&R program.

Process for Developing New Rule: The department invites the interested public to review and provide input on the draft language of this WAC. Draft material and information about how to participate are available by contacting the Department of Social and Health Services representative identified below.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Allen Richards, Program Assistance and Support Services, Medical Assistance Administration, Olympia, WA 98504-5530, phone (360) 586-1008, fax (360) 753-7315, TTY 1-800-848-5429, e-mail richaa@dshs.wa.gov.

November 18, 1998

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit