WSR 19-07-018
[Filed March 11, 2019, 3:05 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 19-03-087.
Title of Rule and Other Identifying Information: WAC 182-531-1730 Telemedicine.
Hearing Location(s): On May 21, 2019, at 10:00 a.m., at the Health Care Authority (HCA), Cherry Street Plaza, Pear Conference Room 107, 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.
Date of Intended Adoption: Not sooner than May 22, 2019.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email, fax 360-586-9727, by May 21, 2019.
Assistance for Persons with Disabilities: Contact Amber Lougheed, phone 360-725-1349, fax 360-586-9727, telecommunication relay services 711, email, by May 17, 2019.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The agency is amending WAC 182-531-1730 Telemedicine, [to] add renal dialysis centers to the list of originating sites. This addition aligns with RCW 41.05.700.
Reasons Supporting Proposal: See purpose.
Statutory Authority for Adoption: RCW 41.05.021, 41.05.160, and 41.05.700.
Statute Being Implemented: RCW 41.05.021, 41.05.160, and 41.05.700.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Jason Crabbe, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-9563; Implementation and Enforcement: Jodi Kunkel, P.O. Box 45506, Olympia, WA 98504-5506, 360-725-9805.
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.
This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:
Is exempt under RCW 19.85.025(3) as the rule content is explicitly and specifically dictated by statute.
March 11, 2019
Wendy Barcus
Rules Coordinator
AMENDATORY SECTION(Amending WSR 15-20-063, filed 10/1/15, effective 11/1/15)
WAC 182-531-1730Telemedicine.
(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) Email, 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) Neurodevelopmental centers;
(h) Physician or other health professional's office;
(i) Renal dialysis centers, except an independent renal dialysis center;
(j) Rural health clinics;
(((j)))(k) Schools; and
(((k)))(l) 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.