Chapter 388-538 WAC
MANAGED CARE
Last Update: 7/18/08

WAC SECTIONS

388-538-050 Definitions.
388-538-060 Managed care and choice.
388-538-061 Voluntary enrollment into managed care -- Washington medicaid integration partnership (WMIP).
388-538-063 GAU clients residing in a designated mandatory managed care plan county.
388-538-065 Medicaid-eligible basic health (BH) enrollees.
388-538-067 Managed care provided through managed care organizations (MCOs).
388-538-068 Managed care provided through primary care case management (PCCM).
388-538-070 Managed care payment.
388-538-095 Scope of care for managed care enrollees.
388-538-100 Managed care emergency services.
388-538-110 The grievance system for managed care organizations (MCO).
388-538-111 Primary care case management (PCCM) grievances and appeals.
388-538-112 The department of social and health services' (DSHS) hearing process for enrollee appeals of managed care organization (MCO) actions.
388-538-120 Enrollee request for a second medical opinion.
388-538-130 Exemptions and ending enrollment in managed care.
388-538-140 Quality of care.
DISPOSITIONS OF SECTIONS FORMERLY CODIFIED IN THIS CHAPTER
388-538-001 Purpose. [Statutory Authority: RCW 74.08.090. 93-17-039 (Order 3621), § 388-538-001, filed 8/11/93, effective 9/11/93. Formerly WAC 388-83-010 (part).]  Repealed by 00-04-080, filed 2/1/00, effective 3/3/00. Statutory Authority: RCW 74.08.090, 74.09.510 and [74.09.]522 and 1115 Federal Waiver, 42 U.S.C. 1396 (a), (e), (p), 42 U.S.C. 1396r-6(b), 42 U.S.C. 1396u-2. 
388-538-066 Children's health insurance program (CHIP) enrollees. [Statutory Authority: RCW 74.08.090, 74.09.510 and[74.09.]522 and 1115 Federal Waiver, 42 U.S.C. 1396 (a), (e), (p), 42 U.S.C. 1396r-6(b), 42 U.S.C. 1396u-2. 00-04-080, § 388-538-066, filed 2/1/00, effective 3/3/00.]  Repealed by 02-01-075, filed 12/14/01, effective 1/14/02. Statutory Authority: RCW 74.09.080, 74.08.510, [74.08.]522, 74.09.450, 1115 Waiver, 42 U.S.C. 1396. 
388-538-080 Managed care exemptions. [Statutory Authority: RCW 74.09.080, 74.08.510, [74.08.]522, 74.09.450, 1115 Waiver, 42 U.S.C. 1396. 02-01-075, § 388-538-080, filed 12/14/01, effective 1/14/02. Statutory Authority: RCW 74.08.090, 74.09.510 and [74.09.]522 and 1115 Federal Waiver, 42 U.S.C. 1396 (a), (e), (p), 42 U.S.C. 1396r-6(b), 42 U.S.C. 1396u-2. 00-04-080, § 388-538-080, filed 2/1/00, effective 3/3/00. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-538-080, filed 7/31/98, effective 9/1/98. Statutory Authority: RCW 74.08.090. 96-24-074, § 388-538-080, filed 12/2/96, effective 1/1/97. Statutory Authority: RCW 74.08.090 and 1995 2nd sp.s. c 18. 95-18-046 (Order 3886), § 388-538-080, filed 8/29/95 effective 9/1/95. Statutory Authority: RCW 74.08.090. 93-17-039 (Order 3621), § 388-538-080, filed 8/11/93, effective 9/11/93.]  Repealed by 03-18-109, filed 9/2/03, effective 10/3/03. Statutory Authority: RCW 74.08.090, 74.09.522
388-538-090 Client's choice of primary care provider. [Statutory Authority: RCW 74.08.090 and 1995 2nd sp.s. c 18. 95-18-046 (Order 3886), § 388-538-090, filed 8/29/95, effective 9/1/95. Statutory Authority: RCW 74.08.090. 93-17-039 (Order 3621), § 388-538-090, filed 8/11/93, effective 9/11/93.]  Repealed by 00-04-080, filed 2/1/00, effective 3/3/00. Statutory Authority: RCW 74.08.090, 74.09.510 and [74.09.]522 and 1115 Federal Waiver, 42 U.S.C. 1396 (a), (e), (p), 42 U.S.C. 1396r-6(b), 42 U.S.C. 1396u-2. 
388-538-150 Managed care medical audit. [Statutory Authority: RCW 74.08.090 and 1995 2nd sp.s. c 18. 95-18-046 (Order 3886), § 388-538-150, filed 8/29/95, effective 9/1/95. Statutory Authority: RCW 74.08.090. 93-17-039 (Order 3621), § 388-538-150, filed 8/11/93, effective 9/11/93.]  Repealed by 00-04-080, filed 2/1/00, effective 3/3/00. Statutory Authority: RCW 74.08.090, 74.09.510 and [74.09.]522 and 1115 Federal Waiver, 42 U.S.C. 1396 (a), (e), (p), 42 U.S.C. 1396r-6(b), 42 U.S.C. 1396u-2.