PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 99-08-120.
Title of Rule: Chapter 388-440 WAC, Exception to rule.
Purpose: To clarify that this chapter does not apply to requests for noncovered medical or dental services or equipment
Statutory Authority for Adoption: RCW 74.04.050, [74.04.]055, [74.04.]057, and 74.08.090.
Statute Being Implemented: RCW 74.04.050, [74.04.]055, [74.04.]057, and 74.08.090.
Summary: The only change is to clarify that these rules do not apply to exceptions to rules that pertain to medical or dental services or related equipment.
Name of Agency Personnel Responsible for Drafting: Leslie Saeger, P.O. Box 45530, Olympia, WA 98504, (360) 664-2315; Implementation and Enforcement: B. J. Bailey, Lacey, Washington, (360) 413-3120.
Name of Proponent: Department of Social and Health Services, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: Will not change the exception to rule process currently used. The only change is to clarify that these rules do not apply to exceptions to rules that pertain to medical or dental services or related equipment.
Proposal Changes the Following Existing Rules: WAC 388-440-0001 and 388-440-0005, this proposed change clarifies that chapter 388-440 WAC does not apply to requests for MAA services or equipment. WAC 388-501-0160 is being proposed separately to explain the process for requesting an exception to rule for a noncovered medical or dental service and equipment.
No small business economic impact statement has been prepared under chapter 19.85 RCW. This rule change does not impact small businesses.
RCW 34.05.328 applies to this rule adoption. These amendments do fit the definition of a significant legislative rule but DSHS is exempt from preparing further analysis under RCW 34.05.328 (5)(b)(iv) (does not change the effect of current rules).
Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on November 9, 1999, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Paige Wall by October 26, 1999, phone (360) 664-6094, TTY (360) 664-6178, e-mail wallpg@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, Paige Wall, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, by November 9, 1999.
Date of Intended Adoption: No earlier than November 10, 1999.
October 1, 1999
Marie Myerchin-Redifer, Manager
Rules and Policies Assistance Unit
2590.5(1) The secretary of the department, or designee, authorizes department staff to request an exception to a rule in the Washington Administrative Code (WAC) for individual cases, except as noted in subsection (5) of this section, when:
(a) The exception would not contradict a specific provision of federal law or state statute; and
(b) The client's situation differs from the majority; and
(c) It is in the interest of overall economy and the client's welfare; and
(d) It increases opportunities for the client to function effectively; or
(e) A client has an impairment or limitation that significantly interferes with the usual procedures required to determine eligibility and payment.
(2) The secretary or the secretary's designee makes the final decision on all requests for exceptions to a rule.
(3) Clients have no fair hearing rights as defined under chapter 388-08 WAC regarding exception to rule decisions by department staff.
(4) Clients who do not agree with a decision on an exception to rule may file a complaint according to chapter 388-426 WAC.
(5) This section does not apply to requests for noncovered medical or dental services or related equipment. See WAC 388-501-0160.
[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-440-0001, filed 7/31/98, effective 9/1/98.]
(1) Clients are notified in writing within ten days of:
(a) The department staff's decision to file an exception to rule request; and
(b) The department's decision to approve or deny an exception to rule request.
(2) The notice will include the complaint procedures as specified in chapter 388-426 WAC.
(3) This section does not apply to notification requirements for exceptions to rules concerning noncovered medical or dental services or related equipment. See WAC 388-501-0160.
[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-440-0005, filed 7/31/98, effective 9/1/98.]