WSR 01-20-114

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed October 3, 2001, 11:38 a.m. ]

     Date of Adoption: September 25, 2001.

     Purpose: The department is adopting rules to reflect long-standing operational policy regarding the services covered by DSHS/MAA and delivered in neurodevelopmental centers. Client eligibility, provider requirements and service limitations are being adopted in rule.

     Statutory Authority for Adoption: RCW 74.09.080.

     Other Authority: RCW 74.09.520 and 74.09.530.

      Adopted under notice filed as WSR 01-16-138 on July 31, 2001.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 1, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 0.
     Effective Date of Rule: Thirty-one days after filing.

September 25, 2001

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

2958.2
NEW SECTION
WAC 388-545-900   Neurodevelopmental centers.   (1) This section describes:

     (a) Neurodevelopmental centers that may be reimbursed as such by the medical assistance administration (MAA);

     (b) Clients who may receive covered services at a neurodevelopmental center; and

     (c) Covered services that may be provided at and reimbursed to a neurodevelopmental center.

     (2) In order to provide and be reimbursed for the services listed in subsection (4) of this section, MAA requires a neurodevelopmental center provider to do all of the following:

     (a) Be contracted with the department of health (DOH) as a neurodevelopmental center;

     (b) Provide documentation of the DOH contract to MAA;

     (c) Sign a core provider agreement with MAA; and

     (d) Receive a neurodevelopmental center provider number from MAA.

     (3) Clients who are twenty years of age or younger and who meet the following eligibility criteria may receive covered services from neurodevelopmental centers:

     (a) For occupational therapy, refer to WAC 388-545-300(2);

     (b) For physical therapy, refer to WAC 388-545-500(2);

     (c) For speech therapy and audiology services, refer to WAC 388-545-700(2); and

     (d) For early and periodic screening, diagnosis and treatment (EPSDT) screening by physicians, refer to WAC 388-529-0200.

     (4) MAA reimburses neurodevelopmental centers for providing the following services to clients who meet the requirements in subsection (3) of this section:

     (a) Occupational therapy services as described in WAC 388-545-300;

     (b) Physical therapy services as described in WAC 388-545-500;

     (c) Speech therapy and audiology services as described in WAC 388-545-700; and

     (d) Specific pediatric evaluations and team conferences that are:

     (i) Attended by the center's medical director; and

     (ii) Identified as payable in MAA's billing instructions.

     (5) In order to be reimbursed, neurodevelopmental centers must meet MAA's billing requirements in WAC 388-502-0020, 388-502-0100 and 388-502-0150.

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