WSR 13-10-062



(Medicaid Program)

[ Filed April 29, 2013, 4:59 p.m. ]

     Subject of Possible Rule Making: Amending WAC 182-500-0075 Medical assistance definitions -- N, 182-500-0080 Medical assistance definitions -- O, 182-500-0085 Medical assistance definitions -- P, 182-502-0005 Core provider agreement (CPA) and 182-530-1000 Outpatient drug program -- General; new section WAC 182-502-0006 Enrollment for nonbilling individual providers; and other rules as appropriate.

     Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 41.05.021.

     Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: These rules are necessary to establish the medicaid agency's authority to designate willing providers as nonbilling providers and to establish rules applicable to those providers who may apply for this new designation. Nonbilling providers are health care professionals who wish to enroll with the agency to only be an ordering, referring, prescribing provider for the Washington medicaid program and who is not otherwise enrolled as a medicaid provider with the agency. This is required for medicaid to be compliant with the Affordable Care Act, while retaining access to clients for providers who qualify for this designation. During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy.

     Process for Developing New Rule: Health care authority (HCA) welcomes the public to take part in developing this rule. If interested, contact the person identified below to receive an early rule draft to review. After the early review, HCA will send a notice of proposed rule making (CR-102) to everyone receiving this notice and anyone who requests a copy.

     Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Wendy L. Boedigheimer, Rules Program Manager, P.O. Box 42716, Olympia, WA 98504-2716, fax (360) 586-9727, TTY 1-800-848-5429, e-mail

April 29, 2013

Kevin M. Sullivan

Rules Coordinator