WSR 24-10-079
PROPOSED RULES
HEALTH CARE AUTHORITY
[Filed April 30, 2024, 10:01 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 24-07-034.
Title of Rule and Other Identifying Information: WAC 182-531-2030 Enhanced rates for pediatric care services and administration of vaccines.
Hearing Location(s): On June 4, 2024, at 10:00 a.m. The health care authority (HCA) holds public hearings virtually without a physical meeting place. To attend the virtual public hearing, you must register in advance https://us02web.zoom.us/webinar/register/WN_iQT4h2BmSw-O-IMXDCFjgg.
If the link opens with an error message, please try using a different browser. After registering, you will receive a confirmation email containing information about joining the public hearing.
Date of Intended Adoption: No sooner than June 5, 2024.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email arc@hca.wa.gov, fax 360-586-9727, by June 4, 2024, by 11:59 p.m.
Assistance for Persons with Disabilities: Contact Johanna Larson, phone 360-725-1349, fax 360-586-9727, telecommunication[s] relay service 711, email Johanna.larson@hca.wa.gov, by May 24, 2024.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: HCA is expanding the age limit for the enhancement rate for pediatric care services and the administration of vaccines provided to clients from age 18 and younger to age 20 and younger.
Reasons Supporting Proposal: See purpose.
Statutory Authority for Adoption: RCW 41.05.021, 41.05.160.
Statute Being Implemented: RCW 41.05.021, 41.05.160.
Rule is not necessitated by federal law, federal or state court decision.
Agency Comments or Recommendations, if any, as to Statutory Language, Implementation, Enforcement, and Fiscal Matters: Not applicable.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Jason Crabbe, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-9563; Implementation and Enforcement: Wendy Steffens, P.O. Box 45500, Olympia, WA 98504-5500, 360-725-5145.
A school district fiscal impact statement is not required under RCW 28A.305.135.
A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.
Scope of exemption for rule proposal from Regulatory Fairness Act requirements:
Is not exempt.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The amendments to the rule would be increasing reimbursement due to the expanding of the age limit from age 18 to age 20 for the enhancement rate for pediatric care services and the administration of vaccines provided to clients.
April 30, 2024
Wendy Barcus
Rules Coordinator
OTS-5284.1
AMENDATORY SECTION(Amending WSR 18-17-047, filed 8/8/18, effective 10/1/18)
WAC 182-531-2030Enhanced rates for pediatric care services and administration of vaccines.
(1) Subject to available funds, the medicaid agency pays an enhanced rate for covered pediatric care services and the administration of vaccines provided to clients age ((eighteen))20 and younger.
(2) For the purposes of this section, pediatric care services are defined as covered evaluation and management services.
(3) The agency uses the resource-based relative value scale (RBRVS) payment methodology described in WAC 182-531-1850 to calculate the enhanced rate.
(4) If the enhanced rate is less than the agency's published fee schedule rate, the agency pays the published rate.
(5) This enhanced rate applies only to pediatric care services and administration of vaccines for clients age ((eighteen))20 and younger that are not already paid at an enhanced rate.