WSR 02-16-054

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed August 1, 2002, 3:55 p.m. ]

Date of Adoption: July 25, 2002.

Purpose: To change the name augmentative communication device (ACD) to speech generating device (SGD) to reflect Medicare terminology and new federal HIPAA (Health Insurance Portability and Accountability Act) definitions; to clarify criteria for covered SGDs; and to bring department policy regarding SGDs into closer alignment with new federal HIPAA regulations.

Citation of Existing Rules Affected by this Order: Amending WAC 388-543-1000, 388-543-1100, 388-543-1300, and 388-543-2200.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.530.

Adopted under notice filed as WSR 01-21-106 on October 23, 2001, and supplemental notice WSR 02-10-115 on April 30, 2002.

Changes Other than Editing from Proposed to Adopted Version: For rules proposed as WSR 01-21-106 and 02-10-115; describing any changes other than editing from proposed version filed as WSR 02-10-115 to adopted version.

The following changes were made as a result of public comments:

WAC 388-543-1000:

"The following definitions and abbreviations and those found in WAC 388-500-0005 apply to this chapter. Defined words and phrases are bolded the first time they are used in the text."

"Fee-for-service means the general payment method MAA uses to reimburse for covered medical services provided to

clients, except those services covered under MAA's prepaid managed care programs."

"Limitation extension means an authorization a process for requesting and approving covered services and reimbursement that to exceeds a coverage limitation (quantity, frequency, or duration) set in WAC, billing instructions, or numbered memoranda. Limitation extensions require prior authorization."

WAC 388-543-1300

"(1) MAA pays only for DME and related supplies, medical supplies and related services that are medically necessary, listed as covered in this chapter, and meet the definition of DME and medical supplies as defined in WAC 388-543-1000 and prescribed per WAC 388-543-1100 and 388-543-1200."

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 4, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.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 4, Repealed 0.
Effective Date of Rule: Thirty-one days after filing.

July 25, 2002

Brian Lindgren, Manager

Rules and Policies Assistance Unit

Reviser's note: The material contained in this filing exceeded the page-count limitations of WAC 1-21-040 for appearance in this issue of the Register. It will appear in the 02-17 issue of the Register.

Washington State Code Reviser's Office