§ 74.46.155. Reconciliation of medicaid resident days to billed days and medicaid payments -- Payments due -- Accrued interest -- Withholding funds
(1) The department shall reconcile medicaid resident days to billed days and medicaid payments for each medicaid nursing facility for the preceding calendar year, or for that portion of the calendar year the provider's contract was in effect.
(2) The contractor shall make any payment owed the department, determined by the process of reconciliation, by the process of settlement at the lower of cost or rate in direct care, therapy care, and support services component rate allocations, as authorized in this chapter, within sixty days after notification and demand for payment is sent to the contractor.
(3) The department shall make any payment due the contractor within sixty days after it determines the underpayment exists and notification is sent to the contractor.
(4) Interest at the rate of one percent per month accrues against the department or the contractor on an unpaid balance existing sixty days after notification is sent to the contractor. Accrued interest shall be adjusted back to the date it began to accrue if the payment obligation is subsequently revised after administrative or judicial review.
(5) The department is authorized to withhold funds from the contractor's payment for services, and to take all other actions authorized by law, to recover amounts due and payable from the contractor, including any accrued interest. Neither a timely filed request to pursue any administrative appeals or exception procedure that the department may establish in rule, nor commencement of judicial review as may be available to the contractor in law, to contest a payment obligation determination shall delay recovery from the contractor or payment to the contractor.
[1998 c 322 § 9.]
Sections: Previous 74.46.030 74.46.040 74.46.050 74.46.060 74.46.080 74.46.090 74.46.100 74.46.155 74.46.165 74.46.190 74.46.200 74.46.220 74.46.230 74.46.240 74.46.250 NextLast modified: April 7, 2009