Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-551 - Alternatives to hospital services
Subchapter I - HOSPICE SERVICES
Hospice-Payment
Section 182-551-1810 - Pediatric palliative care (PPC) case management/coordination services - Client eligibility

Universal Citation: WA Admin Code 182-551-1810

Current through Register Vol. 24-18, September 15, 2024

To receive pediatric palliative care (PPC) case management/coordination services, a person must:

(1) Be twenty years of age or younger;

(2) Be a current recipient of the:

(a) Categorically needy program (CNP);

(b) Limited casualty program - Medically needy program (LCP-MNP);

(c) CNP - Alien emergency medical;

(d) LCP-MNP - Alien emergency medical;

(e) Children's health insurance program (SCHIP); and

(3) Have a life-limiting medical condition that requires case management and coordination of medical services due to at least three of the following circumstances:

(a) An immediate medical need during a time of crisis;

(b) Coordination with family member(s) and providers required in more than one setting (i.e., school, home, and multiple medical offices or clinics);

(c) A life-limiting medical condition that impacts cognitive, social, and physical development;

(d) A medical condition with which the family is unable to cope;

(e) A family member(s) and/or caregiver who needs additional knowledge or assistance with the client's medical needs; and

(f) Therapeutic goals focused on quality of life, comfort, and family stability.

(4) See WAC 182-551-1860 for concurrent palliative and curative care for hospice clients twenty years of age and younger.

Statutory Authority: RCW 41.05.021, Section 2302 of the Patient Protection and Affordable Care Act of 2010 ( P.L. 111-148), and Section 1814(a)(7) of the Social Security Act. 12-09-079, §182-551-1810, filed 4/17/12, effective 5/18/12. 11-14-075, recodified as §182-551-1810, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.520. 05-18-033, § 388-551-1810, filed 8/30/05, effective 10/1/05.

Disclaimer: These regulations may not be the most recent version. Washington may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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