wa-26-18-081: Health Care Authority — WSR 26-18-081

WSR 26-18-081 (26-18)WSR 26-18-081PROPOSED RULESHEALTH CARE AUTHORITY[Filed September 1, 2026, 2:43 p.m.]Original Notice.Preproposal statement of inquiry was filed as WSR 26-11-032.Title of Rule and Other Identifying Information: WAC 182-526-0212 Resident appeals related to department of social and health services-operated facilities and residential settings.Hearing Location(s): On October 6, 2026, at 10:00 a.m. The health care authority (HCA) holds public hearings virtually without a physical meeting place. Virtual public hearings are held via Microsoft Teams webinar. To attend, you must register in advance at https://events.gcc.teams.microsoft.com/event/9e03b114-69d9-465d-aacf-4bc10fba88d8@11d0e217-264e-400a-8ba0-57dcc127d72d. After registering, you will receive a confirmation email containing information about joining the public hearing. You will be able to join the public hearing through most standard internet browsers; you do not need to install Microsoft Teams.Date of Intended Adoption: Not sooner than October 7, 2026.Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email arc@hca.wa.gov, fax 360-586-9727, beginning September 2, 2026, 8:00 a.m., by October 6, 2026, 11:59 p.m.Assistance for Persons with Disabilities: Contact Jessica Nguyen, phone 360-725-1174, fax 360-586-9727, telecommunication relay service 711, email arc@hca.wa.gov, by September 18, 2026.Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: HCA is developing rules to clarify that there is no hearing right to challenge a decision made by a department of social and health services (DSHS) facility or setting where the decision is related to the services and care provided to the resident and is based on the professional judgment of DSHS employees. Reasons Supporting Proposal: In the situation described above, no agency action has occurred as that term is defined in chapter 34.05 RCW. Determinations of eligibility for specific programs may be appealed as described in the program rules.Statutory Authority for Adoption: RCW 41.05.021 and 41.05.160.Statute Being Implemented: RCW 41.05.021 and 41.05.160.Rule is not necessitated by federal law, federal or state court decision.Name of Proponent: HCA, governmental.Name of Agency Personnel Responsible for Drafting: Melinda Froud, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1408; Implementation and Enforcement: Annette Schuffenhauer, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1254.A school district fiscal impact statement is not required under RCW 28A.305.135.A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal: Is exempt under RCW 19.85.025(3) as the rules adopt, amend, or repeal a procedure, practice, or requirement relating to agency hearings; or a filing or related process requirement for applying to an agency for a license or permit.Explanation of exemptions: This rule revision pertains to agency hearings.Scope of exemption for rule proposal:Is fully exempt.September 1, 2026Wendy BarcusRules CoordinatorRDS-7304.1NEW SECTIONWAC 182-526-0212Resident appeals related to department of social and health services—Operated facilities and residential settings.(1) The medicaid agency offers the right to an adjudicative proceeding only when a rule or statute expressly provides the right to an adjudicative proceeding.(2) Medicaid intermediate care facilities for individuals with intellectual disabilities (ICFs/IID) are enrolled medicaid providers, like all other medicaid providers.(3) Residents of facilities or settings operated by the department of social and health services do not have a right to an adjudicative proceeding under this chapter to challenge the action or inaction of such facilities and settings including, but not limited to: ICFs/IID, state-operated living alternatives (SOLA), youth transitional care facilities, and behavioral health and treatment centers.(4) Determinations of medicaid eligibility and services for specific programs are appealable as described in program rules and this chapter.(5) Residents with complaints related to facility/provider standards of care, clinical care decisions, or compliance with state or federal requirements may direct the concerns to the regulatory agencies that oversee the licensing and certification of those facilities.