Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-540 - Kidney disease program and kidney center services
KIDNEY DISEASE PROGRAM (STATE-FUNDED)
Section 182-540-025 - Kidney disease program (KDP) - Application and recertification requirements - KDP contractor
Current through Register Vol. 24-18, September 15, 2024
When a person applies for the kidney disease program (KDP), the KDP contractor must :
(1)
Inform the applicant of the requirements for KDP eligibility as defined in this chapter , provide the applicant with the necessary forms and instructions
to complete the KDP application, and provide the applicant with a copy of the person's rights and responsibilities.
(2) If required, help the applicant submit an application for medical benefits with the department of social and health services (DSHS) community services office or the health benefits exchange.
(3) Inform the applicant of the requirement to apply for medicare and help with the application process. The KDP contractor must obtain a copy of the Social Security Administration's (SSA's) approval or denial of medicare entitlement and keep a copy in the person's record once a determination has been made by SSA.
(4) Determine eligibility using the agency's policies, rules, and instructions and provide the applicant with a timely written approval or denial notice within no more than sixty calendar days from the date of the KDP application.
(5) The KDP contractor may request an extension of the application time from the KDP program manager when extenuating circumstances prevent the person from completing the application or recertification process within the specified time limit.
(6) Forward the completed KDP application and the application documentation to the KDP program manager at the health care authority (HCA). The KDP program manager may amend or terminate a person's certification period within thirty calendar days of receipt if the application is incomplete or inaccurate.
(7) The KDP contractor certifies an eligible person for no more than one year from the first day of the month of application, unless the client:
(8) Within sixty calendar days prior to the end of a person's certification period, the KDP contractor must assist a person with completing a recertification for KDP. To be eligible for ongoing KDP funding, a person must meet the requirements described in WAC 182-540-026(2).
Statutory Authority: 11-14-075, recodified as §182-540-025, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.510, 74.09.520, 74.09.522, and 42 C.F.R. 405.2101. WSR 03-21-039, § 388-540-025, filed 10/8/03, effective 11/8/03. WSR 13-23-007, §182-540-025, filed 11/7/2013, effective 12/8/2013