PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 06-11-085.
Title of Rule and Other Identifying Information: The department is amending WAC 388-503-0505 General eligibility requirements for medical programs.
Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6094), on September 25, 2007, at 10:00 a.m.
Date of Intended Adoption: Not earlier than September 26, 2007.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail schilse@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m. on September 25, 2007.
Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS Rules Consultant, by September 18, 2007, TTY (360) 664-6178, or (360) 664-6097 or by e-mail at johnsjl4@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: To make state rules consistent with federal regulations by requiring medicaid recipients eligible for medicare benefits to apply for and enroll in medicare Part A, Part B and Part D when the state can pay medicare cost sharing as described in chapter 388-517 WAC.
Reasons Supporting Proposal: The federal Centers for Medicare and Medicaid mandate that state plans include the requirement to apply for and enroll in medicare programs when the state can pay medicare cost sharing as described in chapter 388-517 WAC.
Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.530.
Statute Being Implemented: 42 U.S.C., Section 1396a.
Rule is necessary because of federal court decision, US Supreme Court NY State DSS v. Dublino 413 U.S. (1973).
Name of Proponent: Department of social and health services, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Carole McRae, P.O. Box 45534, Olympia, WA 98504-5534, (360) 725-1250.
No small business economic impact statement has been prepared under chapter 19.85 RCW. This rule-making action does not affect small businesses.
A cost-benefit analysis is not required under RCW 34.05.328. Per RCW 34.05.328 (5)(vii), client eligibility rules for medical assistance programs are exempt from the cost-benefit analysis requirement of RCW 34.05.328.
August 7, 2007
Stephanie E. Schiller
Rules Coordinator
3904.1(2) Persons applying for medical coverage are considered first for federally funded or federally matched programs. State-funded programs are considered after federally funded programs are not available to the client except for brief periods when the state-funded programs offer a broad scope of care which meet a specific client need.
(3) Unless otherwise specified in program specific WAC, the eligibility criteria for each medical program is as follows:
(a) Verification of age and identity (chapters 388-404, 388-406, and 388-490 WAC); and
(b) Residence in Washington state (chapter 388-468 WAC); and
(c) Citizenship or immigration status in the United States (chapter 388-424 WAC); and
(d) Possession of a valid Social Security Account Number (chapter 388-476 WAC); and
(e) Assignment of medical support rights to the state of Washington (WAC 388-505-0540); and
(f) Cooperation in securing medical support (chapter 388-422 WAC); and
(g) Application for Medicare and enrollment into Medicare's prescription drug program if:
(i) It is likely that the individual is entitled to Medicare; and
(ii) The state has authority to pay Medicare cost sharing as described in chapter 388-517 WAC.
(h) Countable resources within program limits (chapters 388-470 and 388-478 WAC); and
(((h))) (i) Countable income within program limits
(chapters 388-450 and 388-478 WAC).
(4) In addition to the general eligibility requirements in subsection (3) of this section, each program has specific eligibility requirements as described in applicable WAC.
(5) Persons living in a public institution, including a correctional facility, are not eligible for the department's medical coverage programs. For a person under age twenty or over age sixty-five who is a patient in an institution for mental disease see WAC 388-513-1315(13) for exception.
(6) Persons terminated from SSI or TANF cash grants and those who lose eligibility for categorically needy (CN) medical coverage have their CN coverage continued while their eligibility for other medical programs is redetermined. This continuation of medical coverage is described in chapter 388-434 WAC.
[Statutory Authority: RCW 74.08.090, 74.09.530, and 2003 1st sp.s. c 25. 04-07-141, § 388-503-0505, filed 3/22/04, effective 4/22/04. Statutory Authority: RCW 74.08.090, 74.08A.100, 74.09.080, and 74.09.415. 02-17-030, § 388-503-0505, filed 8/12/02, effective 9/12/02. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-503-0505, filed 7/31/98, effective 9/1/98. Formerly WAC 388-501-0110, 388-503-0305 and 388-505-0501.]