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182-503-0070  <<  182-503-0080 >>   182-503-0090

PDFWAC 182-503-0080

Washington apple healthApplication denials and withdrawals.

(1) We follow the rules about notices and letters in chapter 182-518 WAC. We follow the rules about timelines in WAC 182-503-0060.
(2) We deny your application for apple health coverage when:
(a) You tell us either orally or in writing to withdraw your request for coverage; or
(b) Based on all information we have received from you and other sources within the time frames stated in WAC 182-503-0060, including any extra time given at your request or to accommodate a disability or limited-English proficiency:
(i) We are unable to determine that you are eligible; or
(ii) We determine that you are not eligible.
(c) You are subject to asset verification and do not provide authorization as described in WAC 182-503-0055.
(3) We send you a written notice explaining why we denied your application (per chapter 182-518 WAC).
(4) We reconsider our decision to deny your apple health coverage without a new application from you when:
(a) We receive the information that we need to decide if you are eligible within 30 days of the date on the denial notice;
(b) You give us authorization to verify your assets as described in WAC 182-503-0055 within 30 days of the date on the denial notice;
(c) You request a hearing within ninety days of the date on the denial letter and an administrative law judge (ALJ) or HCA review judge decides our denial was wrong (per chapter 182-526 WAC).
(5) If you disagree with our decision, you can ask for a hearing. If we denied your application because we do not have enough information, the ALJ will consider the information we already have and any more information you give us. The ALJ does not consider the previous absence of information or failure to respond in determining if you are eligible.
[Statutory Authority: RCW 41.05.021, 41.05.160, and 42 U.S.C. Sec. 1396w. WSR 19-21-007, § 182-503-0080, filed 10/3/19, effective 11/3/19. Statutory Authority: RCW 41.05.021, 41.05.160, Public Law 111-148, 42 C.F.R. § 431, 435, and 457, and 45 C.F.R. § 155. WSR 14-16-052, § 182-503-0080, filed 7/29/14, effective 8/29/14.]
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