Purpose: Due to an increase in medical costs paid by the crime victims compensation program, it has been determined that the current appropriation will not be sufficient to carry the program through this biennium. RCW 7.68.080 (2)(b) gives the department the authority to set the service levels and fees no lower than those established by the Department of Social and Health Services under Title 74 RCW. The purpose of this rule is to lower provider reimbursement rates for services to crime victims to those of the Department of Social and Health Services. Lowering the reimbursement rates for services has the least onerous impact on crime victims.

     Citation of Existing Rules Affected by this Order: Amending WAC 296-30-090.

     Statutory Authority for Adoption: RCW 7.68.030.

     Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.

     Reasons for this Finding: In light of this critical financial situation, the CVC program filed an emergency rule to immediately reduce its reimbursement rates to the Department of Social and Health Services (DSHS) reimbursement rates (the lowest rates allowed by law), effective September 1, 2004. L&I will also file a second emergency rule, in order to continue the reimbursement rate at the DSHS rate while the agency works to put a permanent rule in place.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 1, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended [1], Repealed 0.

     Date Adopted: December 30, 2004.

December 30, 2004

Paul Trause

Director

OTS-7333.4

AMENDATORY SECTION(Amending WSR 00-03-056, filed 1/14/00, effective 2/14/00)

WAC 296-30-090   What are the maximum allowable fees?   (1) ((Maximum allowable fees for medical services are those fees published in the Medical Aid Rules and Fee Schedules less any available benefits of public or private insurance.

     (2) Maximum allowable fees for mental health services are those fees published in the Crime Victims Compensation Program Mental Health Treatment Rules and Fees less any available benefits of public or private insurance.

EXCEPTION:

If any of the maximum allowable fees in the publications entitled Medical Aid Rules and Fee Schedules and Crime Victims Compensation Program Mental Health Treatment Rules and Fees are lower than the maximum allowable fees for those procedures established by the department of social and health services under Title 74 RCW, the Title 74 RCW fees are the maximum allowable fees for those procedures.

     (3))) The maximum allowable fees for medical and mental health services will be those rates established by the department of social and health services less any available benefits of public or private insurance.

     (2) The percent of allowed charges authorized for hospital inpatient and outpatient services billed by revenue codes are those rates established by the department of social and health services under Title 74 RCW and WAC 388-550-4500 (1)(a) and 388-550-6000 (1)(a) less any available benefits of public or private insurance.

[Statutory Authority: RCW 7.68.030, 7.68.080, 7.68.130. 00-03-056, § 296-30-090, filed 1/14/00, effective 2/14/00.]

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