Z-0930.1  _______________________________________________

                         SENATE BILL 6051

          _______________________________________________

State of Washington      54th Legislature     1995 Regular Session

By Senators Rinehart, West and Winsley; by request of Department of Social and Health Services

Read first time 03/01/95.  Referred to Committee on Ways & Means.

Clarifying legislative authority to treat, for nursing home reimbursement purposes, nonmedicaid therapy costs as unallowable.

    AN ACT Relating to affirming and clarifying the legislative authority to treat nonmedicaid therapy costs as unallowable, insuring that for medical care recipients, only therapy costs, that are not covered by other payers, may be reimbursed in the per patient day rate; and amending RCW 74.46.190.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

    Sec. 1.  RCW 74.46.190 and 1983 1st ex.s. c 67 s 12 are each amended to read as follows:

    (1) The substance of a transaction will prevail over its form.

    (2) All documented costs which are ordinary, necessary, related to care of medical care recipients, and not expressly unallowable, are to be allowable.  Costs of providing ancillary care are allowable, subject to any applicable cost center limit contained in this chapter, provided documentation establishes the costs were incurred for medical care recipients and other sources of payment to which recipients may be legally entitled, such as private insurance or medicare, were first fully utilized.

    (3) Costs applicable to services, facilities, and supplies furnished to the provider by related organizations are allowable but at the cost to the related organization, provided they do not exceed the price of comparable services, facilities, or supplies that could be purchased elsewhere.

    (4) Beginning January 1, 1985, the payment for property usage is to be independent of ownership structure and financing arrangements.

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