PERMANENT RULES
SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)
Effective Date of Rule: Thirty-one days after filing.
Purpose: The department is striking "for clients through age twenty" that was inadvertently added in WAC 388-535-1065(4). The corrected rule will read: "Each dental-related procedure described under this section is subject to the coverage limitations listed in chapter 388-535 WAC."
Citation of Existing Rules Affected by this Order: Amending WAC 388-535-1065.
Statutory Authority for Adoption: RCW 74.04.050, 74.08.090.
Adopted under notice filed as WSR 07-14-089 on June 29, 2007.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: August 15, 2007.
Stephanie E. Schiller
Rules Coordinator
3894.1(a) General assistance unemployable (GA-U); and
(b) Alcohol and drug abuse treatment and support act (ADATSA).
(2) The department covers the following dental-related services for a client eligible under the GA-U or ADATSA program:
(a) Services provided only as part of dental treatment for:
(i) Limited oral evaluation;
(ii) Periapical or bite-wing radiographs that are medically necessary to diagnose only the client's chief complaint;
(iii) Palliative treatment to relieve dental pain;
(iv) Pulpal debridement to relieve dental pain; or
(v) Endodontic (root canal only) treatment for maxillary and mandibular anterior teeth (cuspids and incisors) when prior authorized).
(b) Tooth extraction when at least one of the following apply:
(i) The tooth has a radiograph apical lesion;
(ii) The tooth is endodontically involved, infected, or abscessed;
(iii) The tooth is not restorable; or
(iv) The tooth is not periodontally stable.
(3) Tooth extractions require prior authorization when:
(i) The extraction of a tooth or teeth results in the client becoming edentulous in the maxillary arch or mandibular arch; and
(ii) A full mouth extraction is necessary because of radiation therapy for cancer of the head and neck.
(4) Each dental-related procedure described under this
section is subject to the coverage limitations listed in
chapter 388-535 WAC ((for clients through age twenty)).
(5) The department does not cover any dental-related services not listed in this section for clients eligible under the GA-U or ADATSA program, including any type of removable prosthesis (denture).
[Statutory Authority: RCW 74.08.090, 74.09.500, 74.09.520. 07-06-041, § 388-535-1065, filed 3/1/07, effective 4/1/07. Statutory Authority: RCW 74.04.050, 74.04.057, and 74.09.530. 04-14-100, § 388-535-1065, filed 7/6/04, effective 8/6/04. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, 2003 1st sp.s. c 25, P.L. 104-191. 03-19-077, § 388-535-1065, filed 9/12/03, effective 10/13/03.]
Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.