WSR 98-02-075

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

[Filed January 7, 1998, 11:14 a.m.]

The Department of Social and Health Services, Medical Assistance Administration, will enforce WAC 388-87-011(1), as permitted by Section 4714 (a)(2) of the Balanced Budget Act of 1997, Public Law 105-33. WAC 388-87-011(1) reads:

Conditions of payment--Medicare deductible and coinsurance--When paid by department.

(1) The department shall pay the deductible and coinsurance amounts for recipients participating in the benefits of Parts A and B of Medicare (Title XVIII of the Social Security Act) when the:

(a) Total combined reimbursement to the provider from Medicare and the department does not exceed the department's fee schedule as described under WAC 388-87-010; and

(b) Provider accepts assignment for Medicare payment.

The department was previously prohibited from enforcing WAC 388-87-011(1) by a permanent injunction issued in a federal court case known as South Sound Radiologists, Inc., et al. v. Soliz, No. C95-1218WD, Judgement Under Fed. R. Civ. P.54(b), January 8, 1996.

However, that injunction was vacated by an order issued in a federal case known as South Sound Radiologists, Inc. et al. v. Quasim, No. C95-1218WD, October 21, 1997.