Section 182-513-1605 - Medicaid alternative care (MAC)-Eligibility(1) The person receiving care must meet the financial eligibility criteria for medicaid alternative care (MAC).(2) To be eligible for MAC services, the person receiving care must: (b) Be assessed as meeting nursing facility level of care under WAC 388-106-0355, and choose to receive services under the MAC program instead of other long-term services and supports;(c) Meet residency requirements under WAC 182-503-0520;(d) Live at home and not in a residential or institutional setting;(e) Have an eligible unpaid caregiver under WAC 388-106-1905;(f) Meet citizenship and immigration status requirements under WAC 182-503-0535(2)(a) or (b); and(g) Be eligible for either:(i) A noninstitutional medicaid program, which provides categorically needy (CN) or alternative benefit plan (ABP) scope of care under WAC 182-501-0060; or(ii) An SSI-related CN program by using spousal impoverishment protections institutionalized (SIPI) spouse rules under WAC 182-513-1660.(3) An applicant whose eligibility is limited to one or more of the following programs is not eligible for MAC: (a) The medically needy program under WAC 182-519-0100;(b) The medicare savings programs under WAC 182-517-0300;(c) The family planning program under WAC 182-505-0115;(d) The family planning only programs under chapter 182-532 WAC;(e) The medical care services (MCS) program under WAC 182-508-0005;(f) The alien emergency medical (AEM) program under WAC 182-507-0110 through 182-507-0120;(g) The state funded long-term care for noncitizens program under WAC 182-507-0125;(h) The kidney disease program under chapter 182-540 WAC; or(i) The tailored supports for older adults (TSOA) program under WAC 182-513-1610.(4) The following rules do not apply to services provided under the MAC benefit: (a) Transfer of asset penalties under WAC 182-513-1363;(b) Excess home equity under WAC 182-513-1350; and(c) Estate recovery under chapter 182-527 WAC.Wash. Admin. Code § 182-513-1605
Adopted by WSR 17-12-019, Filed 5/30/2017, effective 7/1/2017Amended by WSR 23-11-007, Filed 5/4/2023, effective 6/4/2023