Washington Announces Amendments to Medicaid Provider Rules

The Washington Medicaid Purchasing Administration (“MPA”) issued amendments to WAC Chapter 388-502 – Administration of medical programs – Providers. The MPA modified and added additional regulations regarding provider enrollment and eligibility, healthcare record requirements, and dispute processes. The following
regulations are either new or were amended:

388-502-0002 Eligible provider types

388-502-0003 Noneligible provider types

388-502-0005 Core Provider Agreement (CPA)

388-502-0010 When the department enrolls

388-502-0012 When the department does not enroll

388-502-0014 Review and consideration of an applicant’s history

388-502-0016 Continuing requirements

388-502-0018 Change of ownership

388-502-0020 Healthcare record requirements

388-502-0030 Termination of a provider agreement – For cause

388-502-0040 Termination of a provider agreement – For convenience

388-502-0050 Provider dispute of a department decision

388-502-0060 Reapplying for participation

388-502-0230 Provider payment reviews and dispute rights

These revised rules take effect June 9, 2011.

To access the revised rules (with strikeouts and underlining) click here.

A clean version of these rules will be available on the State Legislature’s website.