Original Notice.
Preproposal statement of inquiry was filed as WSR 25-05-044, 24-24-108, 25-02-110, 25-02-069, 25-06-041, and 24-15-085.
Title of Rule and Other Identifying Information: WAC 182-502-0002 Eligible provider types.
Hearing Location(s): On May 27, 2025, at 10:00 a.m. The health care authority (HCA) holds public hearings virtually without a physical meeting place. To attend the virtual public hearing, you must register in advance at https://us02web.zoom.us/webinar/register/WN_tPBE4ot9T0eY4kiqA4mp4A.
If the link above opens with an error message, please try using a different browser. After registering, you will receive a confirmation email containing information about joining the public hearing.
Date of Intended Adoption: May 28, 2025.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email arc@hca.wa.gov, fax 360-586-9727, beginning April 21, 2025, 8:00 a.m., by May 27, 2025, 11:59 p.m.
Assistance for Persons with Disabilities: Contact Johanna Larson, phone 360-725-1349, fax 360-586-9727, telecommunication relay service 711, email Johanna.Larson@hca.wa.gov, by May 9, 2025.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: HCA is updating the types of professionals and organizations that may provide health care services to eligible clients. HCA is making the following amendments in connection with several separate rule-making actions:
(1) Adding independent diagnostic testing facilities to subsection (2)(v) (WSR 25-05-044).
(2) Adding anesthesiologist assistants to subsection (1)(d) (WSR 24-24-108).
(3) Adding and expanding certified peer counselors to subsection (1)(i) (WSR 25-02-110); this replaces the reference to peer counselors currently in subsection (1)(yy)(ii).
(4) Removing early and periodic screening, diagnosis, and treatment clinics from subsection (2)(m) (WSR 25-02-069).
(5) Adding dental therapists to subsection (1)(q) (WSR 25-06-041).
This rule also adds community health workers to subsection (1)(m). The public hearing on that amendment was held on February 25, 2025 (WSR 25-03-102).
Reasons Supporting Proposal: This rule is outdated and needs to be updated with a list of current provider types.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Melinda Froud, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1408; Implementation and Enforcement: Andrea Allen, P.O. Box 45502, Olympia, WA 98504-5502, 360-725-9805.
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. This rule making only updates the list of eligible provider types and does not impose any costs on small businesses.
The following health care professionals, health care entities, suppliers or contractors of service may request enrollment with the Washington state health care authority (medicaid agency) to provide covered health care services to eligible clients. For the purposes of this chapter, health care services include treatment, equipment, related supplies, and drugs.
(1) Professionals:
(a) Advanced registered nurse practitioners;
(b) Advanced social workers;
(c) Advanced social worker associates;
(d) ((Anesthesiologists))Anesthesia providers, as provided in WAC 182-531-0300:
(i) Physician anesthesiologist;
(ii) Anesthesiology resident;
(iii) Certified anesthesiologist assistant; and
(iv) Certified registered nurse anesthetist;
(e) Applied behavior analysis (ABA) professionals, as provided in WAC 182-531A-0800:
(i) Licensed behavior analyst;
(ii) Licensed assistant behavior analyst; and
(iii) Certified behavior technician;
(f) Audiologists;
(g) Behavioral health support specialists (BHSS);
(h) Birth doulas;
(i) Certified peer counselors;
(j) Certified peer specialists;
(k) Certified peer specialist trainees;
(l) Chiropractors;
(((j)))(m) Community health workers (CHWs);
(n) Dentists;
((
(k)))
(o) Dental health aide therapists, as provided in chapter
70.350 RCW;
(((l)))(p) Dental hygienists;
(((m)))(q) Dental therapists;
(r) Denturists;
(((n)))(s) Dietitians or nutritionists;
(((o)))(t) Hearing aid fitters/dispensers;
(((p)))(u) Home health aide credentialed with DOH as nursing assistant certified or nursing assistant registered;
(((q)))(v) Independent clinical social workers;
(((r)))(w) Independent clinical social worker associates;
(((s)))(x) Licensed practical nurse;
(((t)))(y) Marriage and family therapists;
(((u)))(z) Mental health counselors;
(((v)))(aa) Mental health counselor associates;
(((w)))(bb) Mental health care providers;
(((x)))(cc) Midwives;
(((y)))(dd) Naturopathic physicians;
(((z)))(ee) Nurse anesthetist;
(((aa)))(ff) Ocularists;
(((bb)))(gg) Occupational therapists;
(((cc)))(hh) Ophthalmologists;
(((dd)))(ii) Opticians;
(((ee)))(jj) Optometrists;
(((ff)))(kk) Orthodontists;
(((gg)))(ll) Orthotist;
(((hh)))(mm) Osteopathic physicians;
(((ii)))(nn) Osteopathic physician assistants;
(((jj)))(oo) Peer counselors;
(((kk)))(pp) Podiatric physicians;
(((ll)))(qq) Pharmacists;
(((mm)))(rr) Physicians;
(((nn)))(ss) Physician assistants;
(((oo)))(tt) Physical therapists;
(((pp)))(uu) Prosthetist;
(((qq)))(vv) Psychiatrists;
(((rr)))(ww) Psychologists;
(((ss)))(xx) Radiologists;
(((tt)))(yy) Registered nurse;
(((uu)))(zz) Registered nurse delegators;
(((vv)))(aaa) Registered nurse first assistants;
(((ww)))(bbb) Respiratory therapists;
(((xx)))(ccc) Speech/language pathologists; and
(((yy)))(ddd) Substance use disorder professionals((:
(i) Mental health providers; and
(ii) Peer counselors)), including mental health providers.
(2) Agencies, centers and facilities:
(a) Adult day health centers;
(b) Ambulance services (ground and air);
(c) Ambulatory surgery centers (medicare-certified);
(d) Birthing centers (licensed by the department of health);
(e) Cardiac diagnostic centers;
(f) Case management agencies;
(g) Substance use disorder treatment facilities certified by the department of health (DOH);
(h) Withdrawal management treatment facilities certified by DOH;
(i) Community AIDS services alternative agencies;
(j) Community behavioral health support services provider facilities;
(k) Community mental health centers;
(l) Diagnostic centers;
(m) ((Early and periodic screening, diagnosis, and treatment (EPSDT) clinics;
(n))) Family planning clinics;
(((o)))(n) Federally qualified health centers (designated by the federal department of health and human services);
(((p)))(o) Genetic counseling agencies;
(((q)))(p) Health departments;
(((r)))(q) Health maintenance organization (HMO)/managed care organization (MCO);
(((s)))(r) HIV/AIDS case management;
(((t)))(s) Home health agencies;
(((u)))(t) Hospice agencies;
(((v)))(u) Hospitals;
(v) Independent diagnostic testing facilities;
(w) Indian health service facilities/tribal 638 facilities;
(x) Tribal or urban Indian clinics;
(y) Inpatient psychiatric facilities;
(z) Intermediate care facilities for individuals with intellectual disabilities (ICF-IID);
(aa) Kidney centers;
(bb) Laboratories (CLIA certified);
(cc) Maternity support services agencies; maternity case managers; infant case management, first steps providers;
(dd) Neuromuscular and neurodevelopmental centers;
(ee) Nurse services/delegation;
(ff) Nursing facilities (approved by the DSHS aging and long-term support administration);
(gg) Pathology laboratories;
(hh) Pharmacies;
(ii) Private duty nursing agencies;
(jj) Radiology - Stand-alone clinics;
(kk) Rural health clinics (medicare-certified);
(ll) School districts and educational service districts; and
(mm) Sleep study centers.
(3) Suppliers of:
(a) Blood, blood products, and related services;
(b) Durable and nondurable medical equipment and supplies;
(c) Complex rehabilitation technologies;
(d) Infusion therapy equipment and supplies;
(e) Prosthetics/orthotics;
(f) Hearing aids; and
(g) Respiratory care, equipment, and supplies.
(4) Contractors:
(a) Transportation brokers;
(b) Spoken language interpreter services agencies;
(c) Independent sign language interpreters; and
(d) Eyeglass and contact lens providers.