§ 74.09.5249. Special education programs -- Medical services -- Billing agent duties
(1) The agency awarded the contract under RCW 74.09.5245 shall:
(a) Enroll all districts in this state, except those with preexisting contracts under RCW 74.09.5247, as medicaid providers effective the beginning of the 1993-94 school year;
(b) Develop a statewide system of billing the department and private insurers for medical services provided in special education programs;
(c) Train health care practitioners employed by or contracting with districts in medicaid and insurer billing;
(d) Verify the medicaid eligibility of students enrolled in special education programs in each district;
(e) Provide ongoing technical assistance to practitioners and districts; and
(f) Process and forward all medicaid claims to the department and all other claims to private insurers.
(2) For each student, individual districts may, in consultation with the billing agent, deliver to the student's parent or guardian a letter, prepared by the billing agent, requesting the consent of the parent or guardian to bill the student's health insurance carrier for services provided through the special education program. If a district chooses to do this, the letter must be accompanied by a consent form, on which the parent may identify the student's health insurance carrier so that the billing agent may bill the carrier for medical services provided to the student. The letter must clearly state the following:
(a) That the billing program is designed in part to raise additional funds to improve education services;
(b) That under no circumstances will the parent or guardian be personally charged for any portion of the bill not paid by the insurer, including copayments, deductibles, or uncovered services;
(c) That the amount of the billing will apply to the policy's annual deductible even though the parent will not be billed for the amount of the deductible;
(d) That the amount of the billing, will, however, apply towards annual or lifetime benefit caps if these are included in the policy;
(e) That it is possible that their premiums would be increased as a result of their consent;
(f) That if any of the possible negative consequences of consent were to affect them, they are free to withdraw their consent at any time; and
(g) That their consent is entirely voluntary and that the services the student receives through the district will not be affected by their willingness or refusal to consent to the billing of their private insurer.
[1994 c 180 § 3; 1993 c 149 § 5.]
Notes:
Conflict with federal requirements -- Severability -- 1994 c 180: See notes following RCW 74.09.5243.
Conflict with federal requirements -- Severability -- Effective dates -- 1993 c 149: See notes following RCW 74.09.5241.
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Last modified: April 7, 2009