WSR 02-24-072



(Medical Assistance Administration)

[ Filed December 3, 2002, 4:19 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 00-19-030.

Title of Rule: Amending WAC 388-550-2501 Acute physical medicine and rehabilitation (acute PM&R) program -- General, 388-550-2511 Acute PM&R definitions, 388-550-2521 Client eligibility requirements for acute PM&R services, 388-550-2531 Requirements for becoming an MAA Level A or B acute PM&R provider, 388-550-2541 Quality of care for acute PM&R clients through audits and reviews, 388-550-2551 How MAA determines client placement in Level A or B acute PM&R, 388-550-2561 MAA's requirements for authorizing acute PM&R services and 388-550-3381 How MAA pays acute PM&R facilities for Level A services; and repealing WAC 388-550-3401 How MAA pays acute PM&R facilities for Level B services.

Purpose: Incorporates contract language into rule, updates policy, and removes references to acute PM&R Level A and Level B services.

Other Identifying Information: MAA uses the federal Medicare rehabilitation guidelines as a guide for the acute PM&R program.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.520, and 42 C.F.R. 482.56.

Statute Being Implemented: RCW 74.08.090, 74.09.520, and 42 C.F.R. 482.56.

Summary: The department is incorporating contract language into rule, removing Level B services from the program and repealing WAC 388-550-3401. The program will continue to provide acute PM&R services while removing references to Level A and B services.

Reasons Supporting Proposal: The rules replace the contract since contracts are not used to negotiate rates or services provided, and are not required to keep the acute PM&R program operational. Level B services started in 1999 as part of a budget proviso at the request of a nursing facility. This facility is no longer qualified to provide Level B services as a result of dropping its CARF (the Rehabilitation Accreditation Commission) certification, which is required by MAA's acute PM&R program. Since there are currently no nursing facility requests to provide Level B services, and since hospitals are requesting Level A services for clients and not Level B services, the department is eliminating Level B services from the program.

Name of Agency Personnel Responsible for Drafting: Kathy Sayre, P.O. Box 45533, Olympia, WA 98504, (360) 725-1342; Implementation and Enforcement: Larry Linn, P.O. Box 45510, Olympia, WA 98504, (360) 725-1856.

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

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

Explanation of Rule, its Purpose, and Anticipated Effects: The proposed rule incorporates acute PM&R provider contract language into rule, removes references to Level A and Level B acute PM&R services, and updates and clarifies current program policy.

Since contracts are not used to negotiate rates or services provided, and are not required to keep the acute PM&R program operational, the purpose of the rule is to replace the contract. See Purpose, Summary, and Reasons Supporting Proposal above.

The anticipated effects are the acute PM&R contract is no longer needed, and the program will be more cost effective with the elimination of Level B services in nursing facilities and hospitals. The rules clarify that only MAA-authorized hospital facilities may provide acute PM&R program services to eligible clients.

Proposal Changes the Following Existing Rules: The department is repealing WAC 388-550-3401 How MAA pays acute PM&R facilities for Level B services. Level B services are no longer part of the acute PM&R program.

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

RCW 34.05.328 applies to this rule adoption. The proposed rule does meet the definition of a "significant legislative rule" and the department has prepared an evaluation of probable costs and benefits, which may be obtained by contacting the person at the address listed below.

Hearing Location: Blake Office Park (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA 98503, on January 22, 2003, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by January 17, 2003, phone (360) 664-6094, TTY (360) 664-6178, e-mail

Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, e-mail, by 5:00 p.m., January 22, 2003.

Date of Intended Adoption: Not sooner than January 23, 2003.

November 27, 2002

Brian H. 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 03-01 issue of the Register.

Washington State Code Reviser's Office