Section 182-504-0135. Washington apple health—Reinstated coverage pending an appeal.

(1) If you disagree with a Washington apple health (WAH) decision that we (the agency or its designee) made, you have the right to appeal under RCW 74.09.741. The appeal rules are found in chapter 182-526 WAC.

(2) If we end or change your WAH coverage without the advance notice required by WAC 182-518-0025(3), we will reinstate (give back) your WAH coverage back to the date we ended it. If our initial decision to end or change your WAH coverage was otherwise correct, we will send you a new notice that meets the requirements of chapter 182-518 WAC. This is called reinstated coverage.

(3) Generally, you cannot receive reinstated coverage when a change in your WAH coverage is the result of a mass change. A mass change is when rules change that impact coverage for a class of applicants and recipients or due to a legislative or statutory change.

(4) If you receive WAH medically needy coverage, you cannot receive reinstated coverage past the end of the certification period described in WAC 182-504-0020.

(5) We may end your WAH coverage if mail we sent you is returned to us with no forwarding address. We will reinstate your WAH coverage if we learn your new address and you still meet WAH eligibility requirements.

[Statutory Authority: RCW 41.05.021, 41.05.160, Patient Protection and Affordable Care Act (Public Law 111-148), 42 C.F.R. §§ 431, 435, and 457; and 45 C.F.R. § 155. WSR 14-20-094, § 182-504-0135, filed 9/29/14, effective 10/30/14.]

RCW 41.05.021, 41.05.160, Patient Protection and Affordable Care Act (Public Law 111-148), 42 C.F.R. §§ 431, 435, and 457; and 45 C.F.R. § 155. WSR 14-20-094, § 182-504-0135, filed 9/29/14, effective 10/30/14.

Rules

182-526,182-518-0025,182-518,182-504-0020,