Section 182-502-0002. Eligible provider types.  


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  • 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) Anesthesiologists;
    (c) Applied behavior analysis (ABA) professionals, as provided in WAC 182-531-1410 through 182-531-1436:
    (i) Certified agency-affiliated counselors;
    (ii) Certified counselors; and
    (iii) Certified counselor advisors.
    (d) Audiologists;
    (e) Chemical dependency professionals:
    (i) Mental health care providers; and
    (ii) Peer counselors.
    (f) Chiropractors;
    (g) Dentists;
    (h) Dental hygienists;
    (i) Denturists;
    (j) Dietitians or nutritionists;
    (k) Hearing aid fitters/dispensers;
    (l) Marriage and family therapists;
    (m) Mental health counselors;
    (n) Mental health care providers;
    (o) Midwives;
    (p) Naturopathic physicians;
    (q) Nurse anesthetist;
    (r) Occularists;
    (s) Occupational therapists;
    (t) Ophthalmologists;
    (u) Opticians;
    (v) Optometrists;
    (w) Orthodontists;
    (x) Orthotist;
    (y) Osteopathic physicians;
    (z) Osteopathic physician assistants;
    (aa) Peer counselors;
    (bb) Podiatric physicians;
    (cc) Pharmacists;
    (dd) Physicians;
    (ee) Physician assistants;
    (ff) Physical therapists;
    (gg) Prosthetist;
    (hh) Psychiatrists;
    (ii) Psychologists;
    (jj) Radiologists;
    (kk) Registered nurse delegators;
    (ll) Registered nurse first assistants;
    (mm) Respiratory therapists;
    (nn) Social workers; and
    (oo) Speech/language pathologists.
    (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) Chemical dependency treatment facilities certified by the department of social and health services (DSHS) division of behavioral health and recovery (DBHR), and contracted through either:
    (i) A county under chapter 388-810 WAC; or
    (ii) DBHR to provide chemical dependency treatment services.
    (h) Centers for the detoxification of acute alcohol or other drug intoxication conditions (certified by DBHR);
    (i) Community AIDS services alternative agencies;
    (j) Community mental health centers;
    (k) Diagnostic centers;
    (l) Early and periodic screening, diagnosis, and treatment (EPSDT) clinics;
    (m) Family planning clinics;
    (n) Federally qualified health centers (designated by the federal department of health and human services);
    (o) Genetic counseling agencies;
    (p) Health departments;
    (q) Health maintenance organization (HMO)/managed care organization (MCO);
    (r) HIV/AIDS case management;
    (s) Home health agencies;
    (t) Hospice agencies;
    (u) Hospitals;
    (v) Indian health service facilities/tribal 638 facilities;
    (w) Tribal or urban Indian clinics;
    (x) Inpatient psychiatric facilities;
    (y) Intermediate care facilities for the mentally retarded (ICF-MR);
    (z) Kidney centers;
    (aa) Laboratories (CLIA certified);
    (bb) Maternity support services agencies; maternity case managers; infant case management, first steps providers;
    (cc) Neuromuscular and neurodevelopmental centers;
    (dd) Nurse services/delegation;
    (ee) Nursing facilities (approved by the DSHS aging and long-term support administration);
    (ff) Pathology laboratories;
    (gg) Pharmacies;
    (hh) Private duty nursing agencies;
    (ii) Radiology - Stand-alone clinics;
    (jj) Rural health clinics (medicare-certified);
    (kk) School districts and educational service districts;
    (ll) Sleep study centers; and
    (mm) Washington state school districts and educational service districts.
    (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.
    [Statutory Authority: RCW 41.05.021, 2013 c 178, and 2013 2nd sp.s. c 4. WSR 14-06-054, § 182-502-0002, filed 2/27/14, effective 3/30/14. WSR 11-14-075, recodified as § 182-502-0002, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.080, and 74.09.290. WSR 11-11-017, § 388-502-0002, filed 5/9/11, effective 6/9/11.]
RCW 41.05.021, 2013 c 178, and 2013 2nd sp.s. c 4. WSR 14-06-054, § 182-502-0002, filed 2/27/14, effective 3/30/14. WSR 11-14-075, recodified as § 182-502-0002, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.080, and 74.09.290. WSR 11-11-017, § 388-502-0002, filed 5/9/11, effective 6/9/11.

Rules

182-531-1410,182-531-1436,388-810,