Wash. Admin. Code § 182-537-0100

Current through Register Vol. 24-23, December 1, 2024

Section 182-537-0100 - Purpose

The medicaid agency pays contracted school districts, educational service districts, charter schools, and tribal schools for school-based health care services provided to medicaid-eligible children who require early intervention or special education and related services consistent with Sections 1903(c) and 1905(a) of the Social Security Act. The agency pays school districts through fee-for-service. Covered services must:

(1) Identify, treat, and manage the disabilities of a child who requires early intervention or special education and related services;

(2) Be prescribed or recommended by licensed physicians or other licensed health care providers within their scope of practice under state law;

(3) Be medically necessary;

(4) Be included in the child's current individualized education program (IEP) or individualized family service plan (IFSP); and

(5) Be provided in a school setting, the natural environment, an alternate placement in accordance with the Individuals with Disabilities Education Act (IDEA), or by telemedicine.

Wash. Admin. Code § 182-537-0100

Amended by WSR 16-07-141, Filed 3/23/2016, effective 4/23/2016

Amended by WSR 19-04-095, Filed 2/5/2019, effective 3/8/2019

Amended by WSR 20-14-062, Filed 6/26/2020, effective 7/27/2020

Statutory Authority: RCW 41.05.021. 13-05-017, §182-537-0100, filed 2/7/13, effective 3/10/13. 11-14-075, recodified as §182-537-0100, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.500, and 42 C.F.R. 440.110. 09-07-004, § 388-537-0100, filed 3/4/09, effective 4/4/09. Statutory Authority: RCW 74.08.090. 01-02-076, § 388-537-0100, filed 12/29/00, effective 1/29/01. Statutory Authority: RCW 74.04.050 and 74.08.090. 00-01-088, § 388-537-0100, filed 12/14/99, effective 1/14/00.