WSR 21-10-050
PERMANENT RULES
HEALTH CARE AUTHORITY
[Filed April 29, 2021, 8:08 a.m., effective May 30, 2021]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The agency revised this section to eliminate the requirement for date and signature from the medicaid client or the client's designee upon delivery of medical equipment and supplies in order to avoid contact between the client and delivery person. The agency currently has emergency rules, filed under WSR 20-23-038, striking this requirement. Once the public health emergency ends, the agency will conduct rule making to add this requirement back into the rule.
Citation of Rules Affected by this Order: Amending WAC 182-543-2200.
Adopted under notice filed as WSR 21-07-012 on March 4, 2021.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: April 29, 2021.
Wendy Barcus
Rules Coordinator
OTS-2149.1
AMENDATORY SECTION(Amending WSR 18-24-021, filed 11/27/18, effective 1/1/19)
WAC 182-543-2200Proof of delivery.
(1) When a provider delivers an item directly to the client or the client's authorized representative, the provider must furnish the proof of delivery when the medicaid agency requests that information. All of the following apply:
(a) The agency requires a delivery slip as proof of delivery. The proof of delivery slip must:
(i) ((Be signed and dated by the client or the client's authorized representative (the date of signature must be the date the item was received by the client);
(ii))) Include the client's name and a detailed description of the item(s) delivered, including the quantity and brand name; and
(((iii)))(ii) For medical equipment that may require future repairs, include the serial number.
(b) When the provider or supplier submits a claim for payment to the agency, the date of service on the claim must be one of the following:
(i) For a one-time delivery, the date the item was received by the client or the client's authorized representative; or
(ii) For nondurable medical supplies for which the agency has established a monthly maximum, on or after the date the item was received by the client or the client's authorized representative.
(2) When a provider uses a delivery/shipping service to deliver items which are not fitted to the client, the provider must furnish proof of delivery that the client received the equipment and/or supply, when the agency requests that information.
(a) If the provider uses a delivery/shipping service, the tracking slip is the proof of delivery. The tracking slip must include:
(i) The client's name or a reference to the client's package or packages;
(ii) The delivery service package identification number; and
(iii) The delivery address.
(b) If the provider/supplier does the delivering, the delivery slip is the proof of delivery. The delivery slip must include:
(i) The client's name;
(ii) The shipping service package identification number;
(iii) The quantity, detailed description(s), and brand name or names of the items being shipped; and
(iv) For medical equipment that may require future repairs, the serial number.
(c) When billing the agency, use:
(i) The shipping date as the date of service on the claim if the provider uses a delivery/shipping service; or
(ii) The actual date of delivery as the date of service on the claim if the provider/supplier does the delivery.
(3) A provider must not use a delivery/shipping service to deliver items which must be fitted to the client.
(4) Providers must obtain prior authorization when required before delivering the item to the client. The item must be delivered to the client before the provider bills the agency.
(5) The agency does not pay for medical equipment and related items furnished to the agency's clients when:
(a) The medical professional who provides medical justification to the agency for the item provided to the client is an employee of, has a contract with, or has any financial relationship with the provider of the item; or
(b) The medical professional who performs a client evaluation is an employee of, has a contract with, or has any financial relationship with a provider of medical equipment and related items.