H-1298              _______________________________________________

                                                   HOUSE BILL NO. 1119

                        _______________________________________________

State of Washington                              49th Legislature                              1985 Regular Session

By Representative Bond

Read first time 2/8/85 and referred to Committee on Social & Health Services.

AN ACT Relating to nursing home auditing and reimbursement; amending RCW 74.46.640; and adding a new section to chapter 74.46 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.  A new section is added to chapter 74.46 RCW to read as follows:

          (1) As a condition of cost reimbursement by the department, no contractor may charge medical care recipients not receiving public assistance more than one hundred ten percent of the amount charged public assistance medical care recipients for the same services.

          (2) Any contractor violating subsection (1) of this section shall be subject to a suspension of payments pursuant to RCW 74.46.640.

        Sec. 2.  Section 64, chapter 177, Laws of 1980 as amended by section 34, chapter 67, Laws of 1983 1st ex. sess. and RCW 74.46.640 are each amended to read as follows:

          (1) Payments to a contractor may be withheld by the department in each of the following circumstances:

          (a) A required report is not properly completed and filed by the contractor within the appropriate time period, including any approved extension.  Payments will be released as soon as a properly completed report is received;

          (b) State auditors, department auditors, or authorized personnel in the course of their duties are refused access to a nursing home or are not provided with existing appropriate records.  Payments will be released as soon as such access or records are provided;

          (c) A refund in connection with a settlement or rate adjustment is not paid by the contractor when due.  The amount withheld will be limited to the unpaid amount of the refund; ((and))

          (d) Payment for the final thirty days of service under a contract will be held pending final settlement when the contract is terminated; and

(e) A violation of section 1 of this 1985 act.

          (2) No payment will be withheld until written notification of the suspension is provided to the contractor, stating the reason therefor.