WSR 15-17-123
(Washington Apple Health)
[Filed August 19, 2015, 10:13 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 13-17-107.
Title of Rule and Other Identifying Information: WAC 182-531-1730 Telemedicine.
Hearing Location(s): Health Care Authority (HCA), Cherry Street Plaza Building, Sue Crystal Conference Room 106A, 626 8th Avenue, Olympia, WA 98504 (metered public parking is available street side around building. A map is available at or directions can be obtained by calling (360) 725-1000), on September 22, 2015, at 10:00 a.m.
Date of Intended Adoption: Not sooner than September 23, 2015.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 45504, Olympia, WA 98504-5504, delivery 626 8th Avenue, Olympia, WA 98504, e-mail, fax (360) 586-9727, by 5:00 p.m. on September 22, 2015.
Assistance for Persons with Disabilities: Contact Amber Lougheed by September 18, 2015, e-mail or (360) 725-1349, TTY (800) 848-5429 or 711.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: These proposed rules expand the use of telemedicine for Washington apple health clients.
Reasons Supporting Proposal: See Purpose above.
Statutory Authority for Adoption: RCW 41.05.021, 41.05.160.
Statute Being Implemented: RCW 41.05.021, 41.05.160.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Wendy Barcus, P.O. Box 42716, Olympia, WA 98504-2716, (360) 725-1306; Implementation and Enforcement: Lisa Humphrey, P.O. Box 5506, Olympia, WA 98504-5506, (360) 726-1617 [(360) 725-1617].
No small business economic impact statement has been prepared under chapter 19.85 RCW. The agency has determined that the proposed filing does not impose a disproportionate cost impact on small businesses or nonprofits.
A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.
August 19, 2015
Wendy Barcus
Rules Coordinator
WAC 182-531-1730 Telemedicine.
(1) Telemedicine is when a health care practitioner uses HIPAA-compliant, interactive, real-time audio and video telecommunications (including web-based applications) or store and forward technology to deliver covered services that are within his or her scope of practice to a client at a site other than the site where the provider is located. If the service is provided through store and forward technology, there must be an associated office visit between the client and the referring health care provider.
(2) The medicaid agency does not cover the following services as telemedicine:
(a) E-mail, audio only telephone, and facsimile transmissions;
(b) Installation or maintenance of any telecommunication devices or systems; and
(c) Purchase, rental, or repair of telemedicine equipment.
(3) Originating site. An originating site is the physical location of the client at the time the health care service is provided. Approved originating sites are:
(a) Clinics;
(b) Community mental health/chemical dependency settings;
(c) Dental offices;
(d) Federally qualified health centers;
(e) Home or any location determined appropriate by the individual receiving the service;
(f) Hospitals - Inpatient and outpatient;
(g) Physician or other health professional's office;
(h) Rural health clinics;
(i) Schools; and
(j) Skilled nursing facilities.
(4) Distant site. A distant site is the physical location of the health care professional providing the health care service.
(5) The agency pays an additional facility fee per completed transmission to either the originating site or the distant site, as specified in the agency's program-specific billing instructions.
(6) If a health care professional performs a separately identifiable service for the client on the same day as the telemedicine service, documentation for both services must be clearly and separately identified in the client's medical record.
(7) Billing procedures for telemedicine can be found in the agency's program-specific billing instructions.