182-518-0005  <<  182-518-0010 >>   182-518-0015

WAC 182-518-0010

Washington apple healthNotice requirements approval and denial notices.

(1) We send written notice when we approve, reopen, reinstate, or deny coverage for any Washington apple health (WAH) program. The notice includes the information described in WAC 182-518-0005(4) and all of the following:
(a) The WAH coverage for each person approved, reopened or reinstated;
(b) The date that each person's coverage begins (the effective date); and
(c) The dates for which we approved each person's coverage (certification period).
(2) Denial and withdrawal notices include:
(a) The date of denial;
(b) Specific facts and reason(s) supporting the decision;
(c) Specific rules or statutes that support or require the decision; and
(d) Information to get help applying for nonmodified adjusted gross income (MAGI)-based WAH.
(3) If we deny your request for health care coverage or consider it withdrawn because you failed to give us requested information, the denial notice also includes:
(a) A list of the information you did not give us;
(b) The date we asked you for the information and the date it was due;
(c) Notice that we will reconsider your eligibility if we receive any information related to determining your eligibility, including any changes to information we have, within thirty days of the date of the notice;
(d) Information described in subsection (1) of this section; and
(e) Notice of administrative hearing rights.
[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, § 182-518-0010, filed 7/29/14, effective 8/29/14.]
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