AN ACT Relating to
medical assistance federal requirements; amending RCW 11.62.005; reenacting and
amending RCW 74.09.520; adding a new section to chapter 43.20B RCW; creating a
new section; repealing RCW 43.20B.140; and providing an effective date.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF
WASHINGTON:
Sec. 1. RCW 11.62.005 and 1988 c
64 s 24 are each amended to read as follows:
As used in this
chapter, the following terms shall have the meanings indicated.
(1) "Personal
property" shall include any tangible personal property, any instrument
evidencing a debt, obligation, stock, chose in action, license or ownership,
any debt or any other intangible property.
(2)(a)
"Successor" and "successors" shall mean (subject to
subsection (2)(b) of this section):
(i) That person or
those persons who are entitled to the claimed property pursuant to the terms
and provisions of the last will and testament of the decedent or by virtue of
the laws of intestate succession contained in this title; and/or
(ii) The surviving
spouse of the decedent to the extent that the surviving spouse is entitled to
the property claimed as his or her undivided one-half interest in the community
property of said spouse and the decedent; and/or
(iii) The department
of social and health services, to the extent of funds expended or paid, in the
case of claims provided under section 3 of this act; and/or
(iv) This state,
in the case of escheat property.
(b) Any person claiming
to be a successor solely by reason of being a creditor of the decedent or of
the decedent's estate, except for the state as set forth in (a) (iii) and
(iv) of this subsection, shall be excluded from the definition of
"successor".
(3) "Person"
shall mean any individual or organization.
(4)
"Organization" shall include a corporation, government or
governmental subdivision or agency, business trust, estate, trust, partnership
or association, two or more persons having a joint or common interest, or any
other legal or commercial entity.
NEW SECTION. Sec.
2. RCW 43.20B.140 and 1993 c
272 s 2 & 1987 c 283 s 13 are each repealed.
NEW SECTION. Sec.
3. A new section is added
to chapter 43.20B RCW to read as follows:
(1) The department
shall file liens, seek adjustment, or otherwise effect recovery for medical
assistance correctly paid on behalf of an individual as required by this
chapter and 42 U.S.C. Sec. 1396p.
(2) In the case of an
individual who was fifty-five years or age or older when the individual
received medical assistance, the department shall seek adjustment or recovery
from the individual's estate, but only for medical assistance consisting of
nursing facility services, home and community-based services, and related
hospital and prescription drug services.
(3) The department
shall establish procedures consistent with standards established by the federal
department of health and human services and pursuant to 42 U.S.C. Sec. 1396p to
waive recovery when such recovery would work an undue hardship.
(4) The department is
authorized to adopt rules to effect recovery under this section. The
department may adopt by rule later enactments of the federal laws referenced in
this section.
Sec. 4. RCW 74.09.520 and 1993 c
149 s 10 and 1993 c 57 s 1 are each reenacted and amended to read as follows:
(1) The term
"medical assistance" may include the following care and services:
(a) Inpatient hospital services; (b) outpatient hospital services; (c) other
laboratory and x-ray services; (d) nursing facility services; (e) physicians'
services, which shall include prescribed medication and instruction on birth
control devices; (f) medical care, or any other type of remedial care as may be
established by the secretary; (g) home health care services; (h) private duty
nursing services; (i) dental services; (j) physical and occupational therapy
and related services; (k) prescribed drugs, dentures, and prosthetic devices;
and eyeglasses prescribed by a physician skilled in diseases of the eye or by
an optometrist, whichever the individual may select; (l) personal care
services, as provided in this section; (m) hospice services; (n) other
diagnostic, screening, preventive, and rehabilitative services; and (o) like
services when furnished to a child by a school district in a manner consistent
with the requirements of this chapter. For the purposes of this section, the
department may not cut off any prescription medications, oxygen supplies,
respiratory services, or other life-sustaining medical services or supplies.
"Medical
assistance," notwithstanding any other provision of law, shall not include
routine foot care, or dental services delivered by any health care provider,
that are not mandated by Title XIX of the social security act unless there is a
specific appropriation for these services.
(2) The department
shall amend the state plan for medical assistance under Title XIX of the
federal social security act to include personal care services, as defined in 42
C.F.R. 440.170(f), in the categorically needy program.
(3) The department
shall adopt, amend, or rescind such administrative rules as are necessary to
ensure that Title XIX personal care services are provided to eligible persons
in conformance with federal regulations.
(a) These
administrative rules shall include financial eligibility indexed according to
the requirements of the social security act providing for medicaid eligibility.
(b) The rules shall
require clients be assessed as having a medical condition requiring assistance
with personal care tasks. Plans of care must be approved ((by a physician))
and reviewed by a nurse ((every ninety days)).
(4) The department
shall design and implement a means to assess the level of functional disability
of persons eligible for personal care services under this section. The
personal care services benefit shall be provided to the extent funding is
available according to the assessed level of functional disability. Any
reductions in services made necessary for funding reasons should be accomplished
in a manner that assures that priority for maintaining services is given to
persons with the greatest need as determined by the assessment of functional
disability.
(5) The department
shall report to the appropriate fiscal committees of the legislature on the
utilization and associated costs of the personal care option under Title XIX of
the federal social security act, as defined in 42 C.F.R. 440.170(f), in the
categorically needy program. This report shall be submitted by January 1,
1990, and submitted on a yearly basis thereafter.
(6) Effective July 1,
1989, the department shall offer hospice services in accordance with available
funds.
NEW SECTION. Sec.
5. If any part of this act
is found to be in conflict with federal requirements that are a prescribed
condition to the allocation of federal funds to the state, the conflicting part
of this act is inoperative solely to the extent of the conflict and with
respect to the agencies directly affected, and this finding does not affect the
operation of the remainder of this act in its application to the agencies
concerned. The rules under this act shall meet federal requirements that are a
necessary condition to the receipt of federal funds by the state.
NEW
SECTION. Sec. 6. This act shall take
effect July 1, 1994.
