Wac Medical Necessity

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WAC 182-501-0165: - Washington

https://apps.leg.wa.gov/WAC/default.aspx?cite=182-501-0165

The process the agency uses to assess medical necessity is based on: (a) The evaluation of submitted and obtainable medical, dental, or behavioral health evidence as described in subsections (4) and (5) of this section; and. (b) The application of the …

WAC 182-500-0070: - Washington

https://apps.leg.wa.gov/wac/default.aspx?cite=182-500-0070

"Medical care services (MCS)" means the limited scope health care program financed by state funds for clients who are eligible for the aged, blind, or disabled (ABD) cash …

WAC 284-43-5440: - Washington

https://apps.leg.wa.gov/WAC/default.aspx?cite=284-43-5440

Medical necessity determination. (1) An issuer's certificate of coverage and the summary of coverage for the health benefit plan must specifically explain any …

WAC 388-101D-0155: - Washington

https://apps.leg.wa.gov/WAC/default.aspx?cite=388-101D-0155

Medical devices. (1) For purposes of this section the term "medical device" means any piece of medical equipment used to treat a client's assessed need. (2) Use of some medical …

WAC 182-501-0070: - Washington

https://app.leg.wa.gov/WAC/default.aspx?cite=182-501-0070

(1) The medicaid agency or its designee does not pay for any health care service not listed or referred to as a covered health care service under the medical programs described in …

WAC 182-531-1675: - Washington

https://apps.leg.wa.gov/waC/default.aspx?cite=182-531-1675

(i) Letter of medical necessity from the treating surgeon that includes the size and location of the area to be treated, and expected date of planned genital surgery; or …

WAC 182-501-0070 Health care coverage--Noncovered …

https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/wac-182-501-0070-health-care-coverage-noncovered-services

WAC 182-501-0070 Health care coverage--Noncovered services. | Washington State Health Care Authority Free or low-cost health care Employee & retiree benefits Billers, …

WAC 182-538-050 Definitions | Washington State Health …

https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/wac-182-538-050-definitions

(a) The denial or limited authorization of a requested service, including determinations based on the type or level of service, requirements for medical …

WAC 182-500-0070 Definitions -- M. Managed care

https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/wac-182-500-0070-definitions-m-managed-care-organization-mco

"Medical care services (MCS)" means the limited scope health care program financed by state funds for clients who are eligible for the aged, blind, or disabled (ABD) cash …

Chapter 182-531A WAC: - Washington

https://app.leg.wa.gov/WAC/default.aspx?cite=182-531A&full=true

(iv) Requires recertification of medical necessity through continued authorization; and (v) Includes family or caregiver education, support, and training. (4) An …

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