Section 182-543-1100. DME and related supplies, complex rehabilitation technology, prosthetics, orthotics, medical supplies and related services—Client eligibility.

(1) Refer to the table in WAC 182-501-0060 to see which Washington apple health (WAH) programs include DME and related services, complex rehabilitation technology (CRT), prosthetics and orthotics, medical supplies and related services in their benefit package.

(2) For clients eligible under an alien emergency medical (AEM) program, see WAC 182-507-0115.

(3) Clients who are eligible for services under medicare and medicaid (medically needy program-qualified medicare beneficiaries) are eligible for DME and related services, CRT, prosthetics and orthotics, medical supplies and related services.

(4) Clients who are enrolled in a agency-contracted managed care organization (MCO) must arrange for DME and related services, prosthetics and orthotics, medical supplies and related services directly through his or her agency-contracted MCO. The agency does not pay for medical equipment and/or services provided to a client who is enrolled in a agency-contracted MCO, but chose not to use one of the MCO's participating providers.

(5) For clients who reside in a skilled nursing facility, see WAC 182-543-5700.

(6) Clients enrolled in the alternative benefits plan (defined in WAC 182-500-0010) are eligible for DME and related supplies, CRT, prosthetics, orthotics, medical supplies, and related equipment when used as a habilitative service to treat a qualifying condition in accordance with WAC 182-545-400.

[Statutory Authority: RCW 41.05.021 and 2013 c 178. WSR 14-08-035, § 182-543-1100, filed 3/25/14, effective 4/25/14. WSR 11-14-075, recodified as § 182-543-1100, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090 and 74.04.050. WSR 11-14-052, § 388-543-1100, filed 6/29/11, effective 8/1/11; WSR 07-17-062, § 388-543-1100, filed 8/13/07, effective 9/13/07. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.530, and 74.09.700. WSR 06-24-036, § 388-543-1100, filed 11/30/06, effective 1/1/07. Statutory Authority: RCW 74.04.050, 74.04.57 [74.04.057], and 74.08.090. WSR 05-21-102, § 388-543-1100, filed 10/18/05, effective 11/18/05. Statutory Authority: RCW 74.08.090, 34.05.353. WSR 03-12-005, § 388-543-1100, filed 5/22/03, effective 6/22/03. Statutory Authority: RCW 74.08.090, 74.09.530. WSR 02-16-054, § 388-543-1100, filed 8/1/02, effective 9/1/02; WSR 01-01-078, § 388-543-1100, filed 12/13/00, effective 1/13/01.]

RCW 41.05.021 and 2013 c 178. WSR 14-08-035, § 182-543-1100, filed 3/25/14, effective 4/25/14. WSR 11-14-075, recodified as § 182-543-1100, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090 and 74.04.050. WSR 11-14-052, § 388-543-1100, filed 6/29/11, effective 8/1/11; WSR 07-17-062, § 388-543-1100, filed 8/13/07, effective 9/13/07. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.530, and 74.09.700. WSR 06-24-036, § 388-543-1100, filed 11/30/06, effective 1/1/07. Statutory Authority: RCW 74.04.050, 74.04.57 [74.04.057], and 74.08.090. WSR 05-21-102, § 388-543-1100, filed 10/18/05, effective 11/18/05. Statutory Authority: RCW 74.08.090, 34.05.353. WSR 03-12-005, § 388-543-1100, filed 5/22/03, effective 6/22/03. Statutory Authority: RCW 74.08.090, 74.09.530. WSR 02-16-054, § 388-543-1100, filed 8/1/02, effective 9/1/02; WSR 01-01-078, § 388-543-1100, filed 12/13/00, effective 1/13/01.

Rules

182-501-0060,182-507-0115,182-543-5700,182-500-0010,182-545-400,