WSR 99-20-109

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed October 6, 1999, 8:06 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 99-01-167.

Title of Rule: Chapter 388-538 WAC, Managed care.

Purpose: To clarify changes made by the ESA/MAA review of all rules that possibly relate to TANF (temporary assistance to needy families) and CSOs (community service offices). To review the rules for compliance with the Governor's Executive Order 97-02.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.510, and [74.09.]522, 1115 Federal Waiver, 42 U.S.C. 1396 (a), (e) and (p), 1396r-6(b), 1396u-2.

Statute Being Implemented: RCW 74.08.090, 74.09.510, and [74.09.]522, 1115 Federal Waiver, 42 U.S.C. 1396 (a), (e) and (p), 1396r-6(b), 1396u-2.

Summary: The rules have been rewritten to clarify changes made by the ESA/MAA review of all rules that possibly relate to TANF (temporary assistance to needy families) and CSOs (community service offices). The rewritten rules clarify healthy options enrollment criteria, payment methodology, the scope of care, and ending enrollment. New sections are added that establish eligibility criteria for basic health plan enrollees and cross-reference the children's health insurance program (CHIP). The rules have also been reviewed and rewritten to reflect current department policy and to clarify and simplify the language to meet the criteria in the Governor's Executive Order 97-02.

Reasons Supporting Proposal: To comply with the Governor's Executive Order 97-02. To ensure that current department policy and practice is reflected in rule.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: D. Andrea Davis, DPS/MCCM, 619 8th Avenue S.E., Olympia, WA 98501, (360) 586-4877.

Name of Proponent: Department of Social and Health Services, Medical Assistance Administration, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: The rule as rewritten clarifies healthy options enrollment criteria, payment methodology, the scope of care, and ending enrollment. New sections are added that establish eligibility criteria for basic health plan enrollees and that cross-reference the children's health insurance program (CHIP). The amended rules clarify department policy, organizing and simplifying sections for clarity and ease of use.

Proposal Changes the Following Existing Rules: Amends rule listed in Title of Rule above to reflect current department policy and to clarify the language.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the proposed amendments and concludes that no new costs will be imposed on the small businesses affected by them.

RCW 34.05.328 applies to this rule adoption. The rule does meet the definition of a significant legislative rule, and the department has prepared a cost benefit analysis that can be obtained by contacting the person listed in Name of Agency Personnel above.

Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on November 23, 1999, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Paige Wall by November 12, 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 23, 1999.

Date of Intended Adoption: November 24, 1999.

October 1, 1999

Marie Myerchin-Redifer, 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 99-21 issue of the Register.

Washington State Code Reviser's Office