HEALTH CARE AUTHORITY
[Filed October 3, 2018, 9:11 a.m.]
Preproposal statement of inquiry was filed as WSR 18-15-031.
Title of Rule and Other Identifying Information: WAC 182-551-1860 Concurrent care for hospice clients age twenty and younger.
Hearing Location(s): On November 6, 2018, at 10:00 a.m., at the Health Care Authority (HCA), Cherry Street Plaza, Sue Crystal Room 106A, 626 8th Avenue, Olympia, WA 98504. Metered public parking is available street side around building. A map is available at https://www.hca.wa.gov/assets/program/Driving-parking-checkin-instructions.pdf or directions can be obtained by calling 360-725-1000.
Date of Intended Adoption: Not sooner than November 7, 2018.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email firstname.lastname@example.org, fax 360-586-9727, by November 6, 2018.
Assistance for Persons with Disabilities: Contact Amber Lougheed, phone 360-725-1349, fax 360-586-9727, telecommunication relay services 711, email email@example.com, by November 2, 2018.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The agency is amending WAC 182-551-1860 Concurrent care for hospice clients age twenty and younger, to remove language related to exception to rule and allow for medical necessity review of noncovered services. These changes comply with early and periodic screening, diagnostic and treatment (EPSDT) program rules under 42 C.F.R., Sec. 441, Subpart B, and WAC 182-534-0100 EPSDT.
Reasons Supporting Proposal: See purpose.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Vance Taylor, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1344; Implementation and Enforcement: Nancy Hite, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1611.
A school district fiscal impact statement is not required under RCW 28A.305.135
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.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The revisions to this rule do not impose additional compliance costs or requirements on providers.
October 3, 2018
AMENDATORY SECTION(Amending WSR 17-12-082, filed 6/5/17, effective 7/6/17)
WAC 182-551-1860Concurrent care for hospice clients age twenty and younger.
(1) In accordance with 42 U.S.C. 1396d (o)(1)(C), a client age twenty and younger may voluntarily elect hospice care without waiving any rights to services that the client is entitled to under Title XIX Medicaid and Title XXI Children's Health Insurance Program (CHIP) that are related to the treatment of the client's condition for which a diagnosis of terminal illness has been made.
(2) The related services in subsection (1) of this section and medications requested for clients age twenty and younger are subject to the medicaid agency's specific program rules governing those services or medications.
(3) ((If the services in this section include noncovered services listed in WAC 182-501-0070, the provider must request an exception to rule under WAC 182-501-0160.))When a noncovered service is recommended based on the early and periodic screening, diagnosis, and treatment (EPSDT) program, the agency evaluates the request for medical necessity based on the definition in WAC 182-500-0070 and the process in WAC 182-501-0165.
(4) If the medicaid agency denies a request for a covered service, refer to WAC 182-502-0160, billing a client, for when a client may be responsible to pay for a covered service.