WSR 25-19-009
EMERGENCY RULES
HEALTH CARE AUTHORITY
[Filed September 4, 2025, 8:23 a.m., effective September 4, 2025, 8:23 a.m.]
Effective Date of Rule: Immediately upon filing.
Purpose: The health care authority (agency) is amending this rule to expand eligibility for family planning only (FPO) coverage to people age 26 and younger who are confidentially seeking those services.
Citation of Rules Affected by this Order: Amending WAC 182-532-510.
Under RCW
34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.
Reasons for this Finding: FPO services operate under a federal waiver that allows changes in coverage in response to state needs. Under WSR 23-24-065, the agency is amending several rules in chapter 182-532 WAC to expand screening and preventive services for certain sexually transmitted infections and to include coverage for family planning-related services and supplies in connection with a family planning visit. These changes were approved by the Centers for Medicare and Medicaid Services (CMS) as eligible additions to the state program.
The agency originally filed emergency rules for this coverage on December 29, 2023. The agency has continued the emergency rules with successive filings, most recently on August 15, 2025, while waiting for CMS approval of the renewed FPO waiver application. CMS approved the five-year waiver with an effective date of May 1, 2025.
The renewed waiver authorizes the agency to increase the eligibility age limit for FPO coverage for people seeking these services in confidence. This emergency rule making is necessary to amend the age limit in WAC 182-532-510 from 18 to 26 while agency staff continue the permanent rule-making process for this section of WAC. The agency originally filed emergency rules effective May 8, 2025, under WSR 25-11-008, which expires September 5, 2025. The agency filed proposed rules on July 3, 2025, under WSR 25-15-010, and held a public hearing on August 26, 2025.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: September 4, 2025.
Wendy Barcus
Rules Coordinator
RDS-6379.1
AMENDATORY SECTION(Amending WSR 25-06-057, filed 2/28/25, effective 3/31/25)
WAC 182-532-510Family planning only program—Eligibility.
For the purposes of this section, "full-scope coverage" means coverage under either the categorically needy (CN) program, the broadest, most comprehensive scope of health care services covered or the alternative benefits plan (ABP), the same scope of care as CN, applicable to the apple health for adults program.
(1) To be eligible for family planning only services, as defined in WAC 182-532-001, a client must:
(a) Provide a valid Social Security number (SSN) or proof of application to receive an SSN, be exempt from the requirement to provide an SSN as provided in WAC 182-503-0515, or meet good cause criteria listed in WAC 182-503-0515(2);
(b) Be a Washington state resident, as described under WAC 182-503-0520;
(c) Have an income at or below 260 percent of the federal poverty level, as described under WAC 182-505-0100;
(d) Need family planning services; and
(e) Have been denied apple health coverage within the last 30 days, unless the applicant:
(i) Has made an informed choice to not apply for full-scope coverage as described in WAC 182-500-0035 and 182-501-0060, including family planning;
(ii) Is age ((18))26 or younger and seeking services in confidence;
(iii) Is a domestic violence victim who is seeking services in confidence; or
(iv) Has an income of 150 percent to 260 percent of the federal poverty level, as described in WAC 182-505-0100.
(2) A client is not eligible for family planning only medical if the client is:
(a) Pregnant;
(b) Sterilized;
(c) Covered under another apple health program that includes family planning services; or
(d) Covered by concurrent creditable coverage, as defined in RCW
48.66.020, unless they meet criteria in subsection (1)(e) of this section.
(3) The agency does not limit the number of times a client may reapply for coverage.