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 182-540-005 - Kidney disease program (KDP) - Definitions

Current through Register Vol. 24-14, July 15, 2024
The following definitions and those found in chapter
					 182-500 WAC , apply to this chapter for the purpose of administering the kidney
					 disease program.
"Affiliate" -
A facility, hospital, unit,
					 business, or person having an agreement with a
kidney center
to
					 provide specified services to
ESRD
patients;
"Applicant for KDP" -
A person who submits a
					 new application for assistance under the kidney disease program (KDP), or an
					 existing client who has had a break in eligibility of over thirty days;
"Application documentation"
-
A "
					 medical eligibility determination" letter from the department of social and
					 health services (DSHS) and/or a Washington apple health (WAH) eligibility
					 determination letter from the health care authority (the agency) either
					 approving or denying an application for WAH;
"Certification"
-
The kidney
					 center or affiliate has determined a person eligible for the KDP for a defined
					 period of time;
"End-stage renal disease (ESRD)"
-
The stage of renal impairment which is irreversible and
					 permanent, and requires dialysis or kidney transplant to ameliorate uremic
					 symptoms and maintain life. For purposes of the KDP, this includes persons who
					 have received a transplant;
"KDP application" -
The agency Form 13-566
					 which the person completes and submits to the KDP contractor to determine KDP
					 eligibility;
"KDP client"
-
A person who has a
					 diagnosis of ESRD or had a diagnosis of ESRD and has received a kidney
					 transplant and has been determined eligible for the kidney disease program as
					 determined by a KDP contractor;
"KDP contractor"
-
A kidney
					 center or other ESRD facility that has contracted with the health care
					 authority (the agency), kidney disease program to provide ESRD services to KDP
					 clients;
"KDP manual" -
A manual that describes the KDP
					 contract guidelines and procedures for a KDP contractor;
"Kidney center"
-
A facility as
					 defined and certified by the federal government to
provide
ESRD
services
"Kidney disease program (KDP)"
-
A state-funded program managed by the Washington state health care authority
					 that provides financial assistance to eligible persons for the costs of
ESRD
medical care;
"Spenddown" -
The process by which a person
					 uses incurred medical expenses to offset income to meet the financial standards
					 established by the agency. (See WAC
					 182-519-0110.)
Statutory
					 Authority: 11-14-075, recodified as §
											182-540-005, 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, § 388-540-005,
					 filed 10/8/03, effective 11/8/03. Statutory Authority:
					 RCW
					 74.04.050 and
					 74.08.090. WSR 00-01-088, §
					 388-540-005, filed 12/14/99, effective 1/14/00. Statutory Authority:
					 RCW
					 74.08.090,
					 74.04.005 and
					 74.08.025. WSR 98-06-025, §
					 388-540-005, filed 2/24/98, effective 3/27/98. Statutory Authority:
					 RCW
					 74.08.090. WSR 93-16-039 (Order 3600), §
					 388-540-005, filed 7/28/93, effective 8/28/93. WSR 13-23-007, §
											182-540-005, filed 11/7/2013,
					 effective 12/8/2013