WSR 11-05-078



(Medicaid Purchasing Administration)

[ Filed February 15, 2011, 10:50 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 09-05-056.

Title of Rule and Other Identifying Information: New WAC 388-502-0002 Eligible provider types, 388-502-0003 Noneligible provider types, 388-502-0005 Core provider agreement (CPA), 388-502-0012 When the department does not enroll, 388-502-0014 Review and consideration of an applicant's history, 388-502-0016 Continuing requirements, 388-502-0018 Change of ownership, 388-502-0040 Termination of a provider agreement -- For convenience, 388-502-0050 Provider dispute of a department decision and 388-502-0060 Reapplying for participation; and amending 388-502-0010 When the department enrolls, 388-502-0020 Healthcare record requirements, 388-502-0030 Termination of a provider agreement -- For cause, and 388-502-0230 Provider payment reviews and dispute rights.

Hearing Location(s): Office Building 2, Auditorium, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at or by calling (360) 664-6094), on April 5, 2011, at 10:00 a.m.

Date of Intended Adoption: Not sooner than April 6, 2011.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504-5850, delivery Office Building 2, DSHS Headquarters, 1115 Washington, Olympia, WA 98504, e-mail, fax (360) 664-6185, by 5 p.m. on April 5, 2011.

Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by March 22, 2011, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department of social and health services' medicaid purchasing administration (MPA) is proposing to amend WAC 388-502-0010 Payment -- Eligible providers defined, 388-502-0020 General requirements for providers, 388-502-0030 Denying, suspending, and terminating a provider's enrollment, and 388-502-0230 Provider review and appeal.

Reasons Supporting Proposal: These rule amendments and additions are intended to update, clarify, and ensure rules which protect the health and safety of DSHS clients and further ensure program integrity. This includes, but is not limited to, eligible provider types, noneligible provider types, core provider agreement, enrollment, review and consideration of an applicant's history, continuing requirements, change of ownership, healthcare record requirements, termination of a provider for cause or convenience, provider dispute of a department decision, reapplying for participation, and provider review and appeal.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.080, 74.09.290.

Statute Being Implemented: RCW 74.08.090.

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

Name of Proponent: Department of social and health services, medicaid purchasing administration, governmental.

Name of Agency Personnel Responsible for Drafting: Wendy L. Boedigheimer, P.O. Box 45504, Olympia, WA 98504-5504, (360) 725-1306; Implementation: Barbara Lantz, P.O. Box 45530, Olympia, WA 98504-5530, (360) 725-1640; and Enforcement: Andi Hanson, P.O. Box 45506, Olympia, WA 98504-5506, (360) 725-1615.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the proposed rule amendments and determined that there are no new costs associated with these changes and they do not impose disproportionate costs on small businesses.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Andi Hanson, P.O. Box 45506, Olympia, WA 98504-5506, phone (360) 725-1615, fax (360) 586-9727, e-mail

February 7, 2011

Katherine I. Vasquez

Rules Coordinator

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 11-06 issue of the Register.

Washington State Code Reviser's Office