WSR 01-12-071

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Finance Division)

[ Filed June 4, 2001, 4:21 p.m. ]

     Date of Adoption: May 30, 2001.

     Purpose: Chapter 388-05 WAC, Contractor billing requirements -- General, to limit the time vendors and providers can submit billing invoices to DSHS for payment. Vendors and providers would have no more than twelve months from the time a good or service was provided in which to bill the department.

     Statutory Authority for Adoption: RCW 43.17.060.

      Adopted under notice filed as WSR 01-08-077 on April 3, 2001.

     Changes Other than Editing from Proposed to Adopted Version: Changes were made to WAC 388-05-0005 to clarify that this rule does not supercede WAC 388-502-0150. Language was added to WAC 388-05-0010 to allow for exceptions under certain circumstances.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 3, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 3, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 3, Amended 0, Repealed 0.
     Effective Date of Rule: Thirty-one days after filing.

May 30, 2001

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

2928.3
Chapter 388-05 WAC

CONTRACTOR BILLING REQUIREMENTS -- GENERAL


NEW SECTION
WAC 388-05-0001   What is the purpose of this chapter?   The purpose of this chapter is to establish general procedures for contractors to follow when submitting claims for payment to the department of social and health services. Additional requirements may also apply.

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NEW SECTION
WAC 388-05-0005   What contracts does this chapter apply to?   This chapter applies to all contracts for personal or client services as defined in chapter 39.29 RCW and to all interlocal agreements governed by chapter 39.34 RCW. This chapter does not supersede WAC 388-502-0150 titled Time Limits for Providers to Bill Medical Assistance Administration (MAA).

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NEW SECTION
WAC 388-05-0010   How soon does a contractor have to submit claims for payment to the department after the services are rendered?   Each contractor who is rendering authorized services to the department or its clients shall submit claims for payment, as agreed upon between the department and the contractor, no later than twelve months after the date of service. If the claims for payment are not presented within the twelve-month period there shall not be a charge against the state. The twelve-month period may be shortened by contract or regulation. The twelve-month period may be extended by contract or regulation, but only if required by applicable state or federal law or regulation. The department may grant exceptions to the twelve-month period for initial claims when billing delays are caused by either of the following:

     (a) The department's certification or authorization of services for a client for a retroactive period; or

     (b) The provider proves to the department's satisfaction that there are other extenuating circumstances.

This provision shall apply to all claims for payment submitted on or after the effective date.

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