Section 182-514-0260. Program for children under age nineteen.

(1) To qualify for the modified adjusted gross income (MAGI)-based long-term care (LTC) program under this section, a child under age nineteen must meet:

(a) The general eligibility requirements in WAC 182-514-0240; and

(b) Program requirements under WAC 182-505-0210 or 182-505-0117.

(2) If a child under age nineteen is eligible for the premium-based children's program under WAC 182-505-0215, the medicaid agency redetermines the child's eligibility under this section so that the child's family is not required to pay the premium.

(3) The categorically needy (CN) income level for LTC coverage under this section is two hundred ten percent of the federal poverty level after the standard five percentage point income disregard.

(4) To determine countable income for CN coverage under this section, apply MAGI methodology under chapter 182-509 WAC.

(5) The agency approves CN coverage under this section for twelve calendar months (certification period). If the child is discharged from the facility before the end of the certification period, the child remains continuously eligible for CN coverage through the certification period, unless the child ages out of the program, moves out of state, is incarcerated, or dies.

(6) If a child is not eligible for CN coverage under this section, the agency determines the child's eligibility for coverage under the institutional medically needy program described in WAC 182-514-0263.

(7) The institution where the child resides may submit an application on the child's behalf and may act as the child's authorized representative if the child is:

(a) In a court-ordered, out-of-home placement under chapter 13.34 RCW; or

(b) Involuntarily committed to an inpatient treatment program by a court order under chapter 71.34 RCW.

[Statutory Authority: RCW 41.05.021, 41.05.160. WSR 16-04-087, § 182-514-0260, filed 1/29/16, effective 2/29/16. Statutory Authority: RCW 41.05.021 and Patient Protection and Affordable Care Act (P.L. 111-148), 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155. WSR 14-06-068, § 182-514-0260, filed 2/28/14, effective 3/31/14. WSR 12-02-034, recodified as § 182-514-0260, filed 12/29/11, effective 1/1/12. Statutory Authority: RCW 74.04.055, 74.04.057, 74.08.090, 74.09.530, and 42 C.F.R. 441.151. WSR 09-06-029, § 388-505-0260, filed 2/24/09, effective 3/27/09.]

RCW 41.05.021, 41.05.160. WSR 16-04-087, § 182-514-0260, filed 1/29/16, effective 2/29/16. Statutory Authority: RCW 41.05.021 and Patient Protection and Affordable Care Act (P.L. 111-148), 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155. WSR 14-06-068, § 182-514-0260, filed 2/28/14, effective 3/31/14. WSR 12-02-034, recodified as § 182-514-0260, filed 12/29/11, effective 1/1/12. Statutory Authority: RCW 74.04.055, 74.04.057, 74.08.090, 74.09.530, and 42 C.F.R. 441.151. WSR 09-06-029, § 388-505-0260, filed 2/24/09, effective 3/27/09.

Rules

182-514-0240,182-505-0210,182-505-0117,182-505-0215,182-509,182-514-0263,