Subject of Possible Rule Making: The department is proposing the amendment of WAC 388-502-0100 General conditions of payment, 388-519-0100 Eligibility for the medically needy program, 388-865-0217 Psychiatric indigent inpatient program, and other possible rules related to provider reimbursement and client financial obligations.

     Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 71.05.560, 74.04.050, 74.04.055, 74.04.057, 74.08.090, 74.09.500, 74.09.530.

     Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The department is clarifying the existing policy and practice of deducting any amounts required to be paid by clients, such as deductibles, copays, cost sharing, spenddown amounts, or emergency medical expense requirements (EMER), from payments made to providers. There are no new rules in this rule-making action. This action does not change current and long-standing department practice; it is intended only to clarify the already existing policy and rule interpretation. The sole purpose is to promote easier understanding of the policy. The department gives notice that in the process of amending the above-mentioned rules, it may become aware of related rules that should be amended to maintain consistency. The department recognizes the importance of widespread notice of any rule-making action, including that which merely clarifies current policy, and so is filing this according to the provision of RCW 34.05.310(1) in order to ensure such notice.

     Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.

     Process for Developing New Rule: The department invites the interested public to review and provide input on the draft language of this rule. Draft material and information about how to participate may be obtained from the department representative listed below.

     Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Ann Myers, P.O. Box 45533, Olympia, WA 98504-5533, phone (360) 725-1345, fax (360) 586-9727, TTY 1-800-848-5429, e-mail myersea@dshs.wa.gov.

January 6, 2006

Andy Fernando, Manager

Rules and Policies Assistance Unit