H-3278              _______________________________________________

                                                   HOUSE BILL NO. 1547

                        _______________________________________________

State of Washington                              49th Legislature                              1986 Regular Session

By Representatives Lux, D. Nelson and McMullen

Read first time 1/17/86 and referred to Committee on Commerce & Labor.

AN ACT Relating to medical aid billings submitted to the department of labor and industries; adding a new section to chapter 51.36 RCW; and prescribing penalties.

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

NEW SECTION. Sec. 1.  A new section is added to chapter 51.36 RCW to read as follows:

          (1) All providers of medical and other health care services to injured workers shall submit a duplicate copy of any medical billings, fees, or other charges to the worker who received the services or to the worker's authorized representative.  The billing shall be accompanied by a notice clearly informing the worker or representative that the charges have been submitted to the department for payment and that the law allows the worker or worker's representative to verify that such services were rendered in connection with the industrial insurance claim.  The notice shall further state that the worker is entitled to receive one-half of any recovery made by the department under subsection (2) of this section.

          (2) The department shall investigate any billings for services reported by the worker to not have been rendered or to be otherwise erroneous.  In any case in which the department determines that the billing is incorrect, the department shall order recoupment from the provider of any amount incorrectly paid by the department.  One-half of any amount recovered shall be paid to the worker.  The amount paid to the worker shall be construed as benefits under this title and shall be in addition to any other benefits received by the worker under this title.

          (3) Any provider who submits a billing for which recoupment is ordered under subsection (2) of this section shall also be subject to a civil penalty as determined by the director but not to exceed five hundred dollars, for the benefit of the medical aid fund.