HEALTH CARE AUTHORITY

(Washington Apple Health)

(1) The medicaid agency or its designee may file liens to recover the cost of medical assistance or state-only funded long-term care services, or both, correctly paid on behalf of a client consistent with 42 U.S.C. 1396p ((and)), chapters 41.05A and 43.20B RCW, and 182-527 WAC.

(2) ((Prior to)) Before the agency or its designee ((filing)) files a lien under this section, the agency or its designee sends a notice via first class mail to:

(a) The address of the property and other assets subject to the lien;

(b) The probate estate's personal representative, if any;

(c) Any other person known to have title to the affected property ((and/or)) or to the decedent's heir(s) as defined by WAC 182-527-2730, or both; and

(d) The decedent's last known address or the address listed on the title, if any.

(3) The notice in subsection (2) of this section includes:

(a) The decedent's name, identification number, date of birth, and date of death;

(b) The amount of medical assistance or state-only funded long-term care services, or both, correctly paid on behalf of the deceased client that the agency or its designee seeks to recover;

(c) The agency's or its designee's intent to file a lien against the deceased client's property and other assets to recover the amount of medical assistance or state-only funded long-term care services, or both, correctly paid on behalf of the deceased client;

(d) The county in which the property and other assets are located; and

(e) The procedures to contest the agency's or its designee's decision to file a lien by applying for an administrative hearing.

(4) An administrative hearing ((only)) determines only:

(a) ((Whether the medical assistance or state-only funded long-term care services, or both, correctly paid on behalf of the decedent alleged by the agency's or its designee's notice is correct;)) The correctness of the dollar amount paid on behalf of the decedent for medical assistance or state-only funded long-term care services, or both; and

(b) Whether the decedent had legal title to the property((; and

(c) Whether a lien is allowed under the provisions of Title 42 U.S.C. Section 1396p (a) and (b))).

(5) A request for an administrative hearing must:

(a) Be in writing;

(b) State the basis for contesting the lien;

(c) Be signed by the requester and must include the requester's address and telephone number; and

(d) Be served to the office of financial recovery (OFR) as described in WAC 182-527-2870, within twenty-eight calendar days of the date the agency or its designee mailed the notice.

(6) Upon receiving a request for an administrative hearing, the agency or its designee notifies persons known to have title to the property and other assets of the time and place of the administrative hearing.

(7) Persons known to have title to disputed assets ((must not be distributed)) cannot collect them while in litigation.

(8) An administrative hearing under this section is governed by chapters 34.05 RCW and 182-526 WAC and this section. If a provision in this section conflicts with a provision in chapter 182-526 WAC, the provision in this section governs.

(9) If an administrative hearing is conducted in accordance with this ((regulation)) section, and the final agency decision is issued, the agency or its designee ((only)) files a lien against the decedent's property and other assets ((only)) if upheld by the final agency decision.

(10) If no known title holder requests an administrative hearing, the agency or its designee files a lien twenty-eight calendar days after the date the agency or its designee mailed the notice described in subsection (2) of this section.