Revised Code of Washington - RCW Title 74 Public Assistance - Chapter 74.09 Medical Care

74.09.010 Definitions
As used in this chapter: (1) "Children's health program" means the health care services program provided to children under eighteen years of age and in ...

74.09.015 Nurse hotline, when funded
To the extent that sufficient funding is provided specifically for this purpose, the department, in collaboration with the health care authority, shall provide all persons ...

74.09.035 Medical care services -- Eligibility, standards -- Limits
(1) To the extent of available funds, medical care services may be provided to recipients of general assistance, and recipients of alcohol and drug addiction ...

74.09.037 Identification card -- Social security number restriction
Any card issued after December 31, 2005, by the department or a managed health care system to a person receiving services under this chapter, that ...

74.09.050 Secretary's responsibilities and duties -- Personnel -- Medical screeners -- Medical directors
The secretary shall appoint such professional personnel and other assistants and employees, including professional medical screeners, as may be reasonably necessary to carry out the ...

74.09.053 Annual reporting requirement
(1) The department of social and health services, in coordination with the health care authority, shall by November 15th of each year report to the ...

74.09.055 Copayment, deductible, coinsurance, other cost-sharing requirements authorized
The department is authorized to establish copayment, deductible, or coinsurance, or other cost-sharing requirements for recipients of any medical programs defined in RCW 74.09.010, except ...

74.09.075 Employability and disability evaluation -- Medical condition -- Medical reports -- Medical consultations and assistance
The department shall provide (a) for evaluation of employability when a person is applying for public assistance representing a medical condition as a basis for ...

74.09.080 Methods of performing administrative responsibilities
In carrying out the administrative responsibility of this chapter, the department may contract with an individual or a group, may utilize existing local state public ...

74.09.085 Contracts -- Performance measures -- Financial incentives
The secretary shall, in collaboration with other state agencies that administer state purchased health care programs, private health care purchasers, health care facilities, providers, and ...

74.09.110 Administrative personnel -- Professional consultants and screeners
The department shall employ administrative personnel in both state and local offices and employ the services of professional screeners and consultants as found necessary to ...

74.09.120 Purchases of services, care, supplies -- Nursing homes -- Veterans' homes -- Institutions for mentally retarded -- Institutions for mental diseases
The department shall purchase necessary physician and dentist services by contract or "fee for service." The department shall purchase nursing home care by contract and ...

74.09.150 Personnel to be under existing merit system
All personnel employed in the administration of the medical care program shall be covered by the existing merit system under the Washington personnel resources board.[1993 ...

74.09.160 Presentment of charges by contractors
Each vendor or group who has a contract and is rendering service to eligible persons as defined in this chapter shall submit such charges as ...

74.09.180 Chapter does not apply if another party is liable -- Exception -- Subrogation -- Lien -- Reimbursement -- Delegation of lien and subrogation rights
(1) The provisions of this chapter shall not apply to recipients whose personal injuries are occasioned by negligence or wrong of another: PROVIDED, HOWEVER, That ...

74.09.185 Third party has legal liability to make payments -- State acquires rights -- Lien -- Equitable subrogation does not apply
To the extent that payment for covered expenses has been made under medical assistance for health care items or services furnished to an individual, in ...

74.09.190 Religious beliefs -- Construction of chapter
Nothing in this chapter shall be construed as empowering the secretary to compel any recipient of public assistance and a medical indigent person to undergo ...

74.09.200 Audits and investigations -- Legislative declaration -- State authority
The legislature finds and declares it to be in the public interest and for the protection of the health and welfare of the residents of ...

74.09.210 Fraudulent practices -- Penalties
(1) No person, firm, corporation, partnership, association, agency, institution, or other legal entity, but not including an individual public assistance recipient of health care, shall, ...

74.09.220 Liability for receipt of excess payments
Any person, firm, corporation, partnership, association, agency, institution or other legal entity, but not including an individual public assistance recipient of health care, that, without ...

74.09.230 False statements, fraud -- Penalties
Any person, including any corporation, that (1) knowingly makes or causes to be made any false statement or representation of a material fact in any ...

74.09.240 Bribes, kickbacks, rebates -- Self-referrals -- Penalties
(1) Any person, including any corporation, that solicits or receives any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in ...

74.09.250 False statements regarding institutions, facilities -- Penalties
Any person, including any corporation, that knowingly makes or causes to be made, or induces or seeks to induce the making of, any false statement ...

74.09.260 Excessive charges, payments -- Penalties
Any person, including any corporation, that knowingly: (1) Charges, for any service provided to a patient under any medical care plan authorized under this chapter, ...

74.09.270 Failure to maintain trust funds in separate account -- Penalties
(1) Any person having any patient trust funds in his possession, custody, or control, who, knowing that he is violating any statute, regulation, or agreement, ...

74.09.280 False verification of written statements -- Penalties
The secretary of social and health services may by rule require that any application, statement, or form filled out by suppliers of medical care under ...

74.09.290 Department audits and investigations of providers -- Patient records -- Penalties
The secretary of the department of social and health services or his authorized representative shall have the authority to: (1) Conduct audits and investigations of ...

74.09.300 Department to report penalties to appropriate licensing agency or disciplinary board
Whenever the secretary of the department of social and health services imposes a civil penalty under RCW 74.09.210, or terminates or suspends a provider's eligibility ...

74.09.402 Children's health care -- Findings -- Intent
(1) The legislature finds that: (a) Improving the health of children in Washington state is an investment in a productive and successful next generation. The ...

74.09.460 Children's affordable health coverage -- Findings -- Intent
(1) The legislature finds that parents have a responsibility to: (a) Enroll their children in affordable health coverage; (b) Ensure that their children receive appropriate ...

74.09.470 Children's affordable health coverage -- Department duties
(1) Consistent with the goals established in RCW 74.09.402, through the program authorized in this section, the department shall provide affordable health care coverage to ...

74.09.480 Performance measures -- Provider rate increases -- Report
(1) The department, in collaboration with the department of health, health carriers, local public health jurisdictions, children's health care providers including pediatricians, family practitioners, and ...

74.09.490 Children's mental health -- Improving medication management and care coordination
(1)(a) The department, in consultation with the evidence-based practice institute established in RCW 71.24.061, shall develop and implement policies to improve prescribing practices for treatment ...

74.09.500 Medical assistance -- Established
There is hereby established a new program of federal-aid assistance to be known as medical assistance to be administered by the state department of social ...

74.09.510 Medical assistance -- Eligibility
Medical assistance may be provided in accordance with eligibility requirements established by the department, as defined in the social security Title XIX state plan for ...

74.09.515 Medical assistance -- Coverage for youth released from confinement
(1) The department shall adopt rules and policies providing that when youth who were enrolled in a medical assistance program immediately prior to confinement are ...

74.09.520 Medical assistance -- Care and services included -- Funding limitations
(1) The term "medical assistance" may include the following care and services: (a) Inpatient hospital services; (b) outpatient hospital services; (c) other laboratory and X-ray ...

74.09.521 Medical assistance -- Program standards for mental health services for children
(1) To the extent that funds are specifically appropriated for this purpose the department shall revise its medicaid healthy options managed care and fee-for-service program ...

74.09.522 Medical assistance -- Agreements with managed health care systems required for services to recipients of temporary assistance for needy families -- Principles to be applied in purchasing managed health care
(1) For the purposes of this section, "managed health care system" means any health care organization, including health care providers, insurers, health care service contractors, ...

74.09.5221 Medical assistance -- Federal standards -- Waivers -- Application
To the extent that federal statutes or regulations, or provisions of waivers granted to the department of social and health services by the federal department ...

74.09.5225 Medical assistance -- Payments for services provided by rural hospitals
(1) Payments for recipients eligible for medical assistance programs under this chapter for services provided by hospitals, regardless of the beneficiary's managed care enrollment status, ...

74.09.5227 Implementation date -- Payments for services provided by rural hospitals
The department shall implement the program created in RCW 74.09.5225 within sixty days of September 20, 2001, regardless of the beneficiary's managed care status.[2001 2nd ...

74.09.523 PACE program -- Definitions -- Requirements
(1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise. (a) "PACE" means the program of all-inclusive care for ...

74.09.5241 Special education programs -- Medical services -- Finding -- Intent
The legislature finds that there is increasing demand for medical services provided through the state's special education programs and that many of these services qualify ...

74.09.5243 Special education programs -- Definitions
Unless the context clearly requires otherwise, the following definitions apply throughout RCW 74.09.5241 through 74.09.5253 and 74.09.5254 through 74.09.5256. (1) "District" means a school district, ...

74.09.5245 Special education programs -- Medical services -- Billing agent contract process
The superintendent of public instruction shall take necessary steps to establish a competitive bidding process for a contract to act as the state's billing agent ...

74.09.5247 Special education programs -- Medical services -- District as billing agent -- Administrative fee
(1) Chapter 149, Laws of 1993 does not apply to contracts between individual districts and private firms entered into for the purpose of billing either ...

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, ...

74.09.5251 Special education programs -- Medical services -- Categories of services -- Reimbursement system
The medical assistance administration in the department of social and health services shall establish categories of medical services and a reimbursement system based on the ...

74.09.5253 Special education programs -- Medical services -- Student information -- Report to legislature
(1) Each district shall participate in the program of billing for medical services provided in the district's special education program. Each participating district shall provide ...

74.09.5254 Special education programs -- Medical services -- Reports to superintendent of public instruction
(1) Each district that has elected to act as its own billing agent under RCW 74.09.5247(2) and each firm that is a party to a ...

74.09.5255 Special education programs -- Medical services -- Incentive payments
Of the projected federal medicaid and private insurance revenue collected under RCW 74.09.5249, one-half of the percent of potential medicaid eligible students billed by the ...

74.09.5256 Special education programs -- Medical services -- Disbursement of revenue
(1) Districts shall reassign medicaid payments to be received under RCW 74.09.5249 through 74.09.5253, 74.09.5254 and 74.09.5255, and this section to the superintendent of public ...

74.09.530 Medical assistance -- Powers and duties of department
(1) The amount and nature of medical assistance and the determination of eligibility of recipients for medical assistance shall be the responsibility of the department ...

74.09.540 Medical assistance -- Working disabled -- Intent
(1) It is the intent of the legislature to remove barriers to employment for individuals with disabilities by providing medical assistance to the working disabled ...

74.09.545 Medical assistance or limited casualty program -- Eligibility -- Agreements between spouses to transfer future income -- Community income
(1) An agreement between spouses transferring or assigning rights to future income from one spouse to the other shall be invalid for purposes of determining ...

74.09.555 Medical assistance -- Reinstatement upon release from confinement -- Expedited eligibility determinations
(1) The department shall adopt rules and policies providing that when persons with a mental disorder, who were enrolled in medical assistance immediately prior to ...

74.09.565 Medical assistance for institutionalized persons -- Treatment of income between spouses
(1) An agreement between spouses transferring or assigning rights to future income from one spouse to the other shall be invalid for purposes of determining ...

74.09.575 Medical assistance for institutionalized persons -- Treatment of resources
(1) The department shall promulgate rules consistent with the treatment of resources provisions of section 1924 of the social security act entitled "Treatment of Income ...

74.09.585 Medical assistance for institutionalized persons -- Period of ineligibility for transfer of resources
(1) The department shall establish standards consistent with section 1917 of the social security act in determining the period of ineligibility for medical assistance due ...

74.09.595 Medical assistance for institutionalized persons -- Due process procedures
The department shall in compliance with section 1924 of the social security act adopt procedures which provide due process for institutionalized or community spouses who ...

74.09.600 Post audit examinations by state auditor
Nothing in this chapter shall preclude the state auditor from conducting post audit examinations of public funds pursuant to RCW 43.09.330 or other applicable law.[1977 ...

74.09.650 Prescription drug assistance program
(1) To the extent funds are appropriated specifically for this purpose, and subject to any conditions placed on appropriations made for this purpose, the department ...

74.09.655 Smoking cessation assistance
The department shall provide coverage under this chapter for smoking cessation counseling services, as well as prescription and nonprescription agents when used to promote smoking ...

74.09.660 Prescription drug education for seniors -- Grant qualifications
Each of the state's area agencies on aging shall implement a program intended to inform and train persons sixty-five years of age and older in ...

74.09.700 Medical care -- Limited casualty program
(1) To the extent of available funds and subject to any conditions placed on appropriations made for this purpose, medical care may be provided under ...

74.09.710 Chronic care management programs -- Medical homes -- Definitions
(1) The department of social and health services, in collaboration with the department of health, shall: (a) Design and implement medical homes for its aged, ...

74.09.715 Access to dental care
Within funds appropriated for this purpose, the department shall establish two dental access projects to serve seniors and other adults who are categorically needy blind ...

74.09.720 Prevention of blindness program
(1) A prevention of blindness program is hereby established in the department of social and health services to provide prompt, specialized medical eye care, including ...

74.09.725 Prostate cancer screening
The department shall provide coverage for prostate cancer screening under this chapter, provided that the screening is delivered upon the recommendation of the patient's physician, ...

74.09.730 Disproportionate share hospital adjustment
In establishing Title XIX payments for inpatient hospital services: (1) The department of social and health services shall provide a disproportionate share hospital adjustment considering ...

74.09.740 Amendments to state plan -- Federal approval required
The department must seek approval from the federal health care financing administration of any amendments to the existing state plan or waivers necessary to ensure ...

74.09.755 AIDS -- Community-based care -- Federal social security act waiver
The department shall prepare and request a waiver under section 1915(c) of the federal social security act to provide community based long-term care services to ...

74.09.760 Short title -- 1989 1st ex.s. c 10
This act may be known and cited as the "maternity care access act of 1989."[1989 1st ex.s. c 10 § 1.] ...

74.09.770 Maternity care access system established
(1) The legislature finds that Washington state and the nation as a whole have a high rate of infant illness and death compared with other ...

74.09.780 Reservation of legislative power
The legislature reserves the right to amend or repeal all or any part of this chapter [subchapter] at any time and there shall be no ...

74.09.790 Definitions
Unless the context clearly requires otherwise, the definitions in this section apply throughout RCW 74.09.760 through 74.09.820 and 74.09.510: (1) "At-risk eligible person" means an ...

74.09.800 Maternity care access program established
The department shall, consistent with the state budget act, develop a maternity care access program designed to ensure healthy birth outcomes as follows: (1) Provide ...

74.09.810 Alternative maternity care service delivery system established -- Remedial action report
(1) The department shall establish an alternative maternity care service delivery system, if it determines that a county or a group of counties is a ...

74.09.820 Maternity care provider's loan repayment program
To the extent that federal matching funds are available, the department or the *department of health if one is created shall establish, in consultation with ...

74.09.850 Conflict with federal requirements
If any part of this chapter is found to conflict with federal requirements which are a prescribed condition to the allocation of federal funds to ...

74.09.900 Other laws applicable
All the provisions of Title 74 RCW, not otherwise inconsistent herewith, shall apply to the provisions of this chapter.[1959 c 26 § 74.09.900. Prior: 1955 ...

74.09.910 Severability -- 1979 ex.s. c 152
If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application ...