WSR 23-10-033
PREPROPOSAL STATEMENT OF INQUIRY
HEALTH CARE AUTHORITY
[Filed April 27, 2023, 12:10 p.m.]
Subject of Possible Rule Making: WAC 182-500-0075 Medical assistance definitionsN, 182-500-0085 Medical assistance definitionsP, 182-502-0005 Core provider agreement (CPA), 182-502-0030 Termination of provider agreementFor cause, 182-502-0270 Review of agency's provider dispute decision; chapter 182-530 WAC, Prescription drugs (outpatient); WAC 182-531-0250 Who can provide and bill for physician-related and health care professional services; and other related rules as appropriate.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 41.05.021, 41.05.160.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The agency is amending these rules to update language in WAC 182-502-0030 to remove the term "agreement" from the WAC title and replace it with "enrollment." The agency is also removing "core provider agreement" from subsection (1) and replacing it with "enrollment" to provide clarity that all providers (not just those with a CPA) are subject to the rules. Additionally, the agency will update the WAC reference in subsection (1)(a)(ii) from WAC 246-934-100 to chapter 246-16 WAC to align with the correct department of health definition of sexual misconduct. The agency will amend the definition of provider in WAC 182-500-0085 to include servicing providers, nonbilling providers, providers with a CPA, and providers with other contracts with the medicaid agency. The agency will also update the term "performing provider" to "servicing provider" in WAC 182-531-0250, 182-530-1000, and 182-502-0005 to align with consistent agency language. During the course of this review, HCA may identify additional related changes that are required in order to improve clarity or update policy.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The Centers for Medicare and Medicaid Services.
Process for Developing New Rule: The agency 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, the agency 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 Valerie Freudenstein, Rule-Making Questions, P.O. Box 42716, Olympia, WA 98504-2716, phone 360-725-1344, fax 360-586-9727, telecommunication[s] relay service (TRS) 711, email valerie.freudenstein@hca.wa.gov, website www.hca.wa.gov/about-hca/rulemaking; or Josh Morse, Program Questions, P.O. Box 45502, Olympia, WA 98504-5502, phone 360-725-0839, fax 360-586-9727, TRS 711, email josh.morse@hca.wa.gov, website www.hca.wa.gov/about-hca/rulemaking.
April 27, 2023
Wendy Barcus
Rules Coordinator