H-3802              _______________________________________________

 

                                                   HOUSE BILL NO. 1814

                        _______________________________________________

 

State of Washington                              49th Legislature                              1986 Regular Session

 

By Representatives Day, West, Tanner and Ballard

 

 

Read first time 1/23/86 and referred to Committee on Ways & Means.

 

 


AN ACT Relating to unallowable costs; and amending RCW 74.46.410.

 

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

 

        Sec. 1.  Section 41, chapter 177, Laws of 1980 as amended by section 17, chapter 67, Laws of 1983 1st ex. sess. and RCW 74.46.410 are each amended to read as follows:

          (1) Costs will be unallowable if they are not documented, necessary, ordinary, and related to the provision of care services to authorized patients.

          (2) Unallowable costs include, but are not limited to, the following:

          (a) Costs of items or services not covered by the medical care program.  Costs of such items or services will be unallowable even if they are indirectly reimbursed by the department as the result of an authorized reduction in patient contribution;

          (b) Costs of services and items provided to recipients which are covered by the department's medical care program but not included in care services established by the department under this chapter;

          (c) Costs associated with a capital expenditure subject to section 1122 approval (part 100, Title 42 C.F.R.) if the department found it was not consistent with applicable standards, criteria, or plans.  If the department was not given timely notice of a proposed capital expenditure, all associated costs will be unallowable up to the date they are determined to be reimbursable under applicable federal regulations;

          (d) Costs associated with a construction or acquisition project requiring certificate of need approval pursuant to chapter 70.38 RCW if such approval was not obtained;

          (e) Interest costs other than those provided by RCW 74.46.290 on and after the effective date of RCW 74.46.530;

          (f) Salaries or other compensation of owners, officers, directors, stockholders, and others associated with the contractor or home office, except compensation paid for service related to patient care;

          (g) Costs in excess of limits or in violation of principles set forth in this chapter;

          (h) Costs resulting from transactions or the application of accounting methods which circumvent the principles of the cost-related reimbursement system set forth in this chapter;

          (i) Costs applicable to services, facilities, and supplies furnished by a related organization in excess of the lower of the cost to the related organization or the price of comparable services, facilities, or supplies purchased elsewhere;

          (j) Bad debts of non-Title XIX recipients.  Bad debts of Title XIX recipients are allowable if the debt is related to covered services, it arises from the recipient's required contribution toward the cost of care, the provider can establish that reasonable collection efforts were made, the debt was actually uncollectible when claimed as worthless, and sound business judgment established that there was no likelihood of recovery at any time in the future;

          (k) Charity and courtesy allowances;

          (l) Cash, assessments, or other contributions, excluding dues, to charitable organizations, professional organizations, trade associations, or political parties, and costs incurred to improve community or public relations;

          (m) Vending machine expenses;

          (n) Expenses for barber or beautician services not included in routine care;

          (o) Funeral and burial expenses;

          (p) Costs of gift shop operations and inventory;

          (q) Personal items such as cosmetics, smoking materials, newspapers and magazines, and clothing, except those used in patient activity programs;

          (r) Fund-raising expenses, except those directly related to the patient activity program;

          (s) Penalties and fines;

          (t) Expenses related to telephones, televisions, radios, and similar appliances in patients' private accommodations;

          (u) Federal, state, and other income taxes;

          (v) Costs of special care services except where authorized by the department;

          (w) Expenses of key-man insurance and other insurance or retirement plans not made available to all employees;

          (x) Expenses of profit-sharing plans;

          (y)  Expenses related to the purchase and/or use of private or commercial airplanes which are in excess of what a prudent contractor would expend for the ordinary and economic provision of such a transportation need related to patient care;

          (z) Personal expenses and allowances of owners or relatives;

          (aa) All expenses of maintaining professional licenses or membership in professional organizations ((and association dues or that portion of association dues attributable to membership in national organizations));

          (bb) Costs related to agreements not to compete;

          (cc) Amortization of goodwill;

          (dd)  Expenses related to vehicles which are in excess of what a prudent contractor would expend for the ordinary and economic provision of transportation needs related to patient care;

          (ee) Legal and consultant fees in connection with a fair hearing against the department where a decision is rendered in favor of the department or where otherwise the determination of the department stands;

          (ff)  Legal and consultant fees of a contractor or contractors in connection with a lawsuit against the department;

          (gg) Lease acquisition costs and other intangibles not related to patient care;

          (hh) All rental or lease costs other than those provided in RCW 74.46.300 on and after the effective date of RCW 74.46.510 and 74.46.530.