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PDFWAC 182-518-0005

Washington apple healthNotice requirementsGeneral.

(1) For the purposes of this chapter, "we" refers to the agency or its designee and "you" refers to the applicant for, or recipient of, health care coverage.
(2) This section applies only to notices and letters that we send about eligibility for Washington apple health (WAH) programs. WAC 182-501-0165 applies to notices and letters regarding prior authorization or other action on requests to cover specific fee-for-service health care services.
(3) We send you written notices (letters) when we:
(a) Approve you for health care coverage for any program;
(b) Reconsider your application for other types of health care coverage based on new information;
(c) Deny you health care coverage (including because you withdrew your application) for any program (according to rules in WAC 182-503-0080);
(d) Ask you for more information to decide if you can start or renew health care coverage;
(e) Renew your health care coverage; or
(f) Change or terminate your health care coverage, even if we approve you for another kind of coverage.
(4) We send notices to you in your primary language if you ask us to and in English according to the rules in WAC 182-503-0110. If you need help to apply for or access your health care coverage due to a disability, we follow the equal access rules in WAC 182-503-0120.
(5) All WAH notices we send you include the following information:
(a) The date of the notice;
(b) Specific contact information for you if you have questions or need help with the notice;
(c) Your appeal rights, if an appeal is available, and the availability of potentially free legal assistance; and
(d) Other information required by state or federal law.
[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, § 182-518-0005, filed 7/29/14, effective 8/29/14.]
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