_______________________________________________
HOUSE
BILL 1162
_______________________________________________
Passed
Legislature - 1997 Regular Session
State
of Washington 55th Legislature 1997 Regular Session
By
Read
first time 01/16/97. Referred to Committee on Health Care.
Providing for delegation of lien and subrogation rights to medical
health care systems by contract.
AN
ACT Relating to delegation of lien and subrogation rights to medical health
care systems by contract; and amending RCW 74.09.180 and 43.20B.060.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec.
1. RCW
74.09.180 and 1990 c 100 s 2 are each amended to read as follows:
(1)
The provisions of this chapter shall not apply to recipients whose personal
injuries are occasioned by negligence or wrong of another: PROVIDED, HOWEVER,
That the secretary may furnish assistance, under the provisions of this
chapter, for the results of injuries to or illness of a recipient, and the
department shall thereby be subrogated to the recipient's rights against the
recovery had from any tort feasor or the tort feasor's insurer, or both, and
shall have a lien thereupon to the extent of the value of the assistance
furnished by the department. To secure reimbursement for assistance provided
under this section, the department may pursue its remedies under RCW
43.20B.060.
(2)
The rights and remedies provided to the department in this section to secure
reimbursement for assistance, including the department's lien and subrogation
rights, may be delegated to a managed health care system by contract entered
into pursuant to RCW 74.09.522. A managed health care system may enforce all
rights and remedies delegated to it by the department to secure and recover
assistance provided under a managed health care system consistent with its
agreement with the department.
Sec.
2. RCW
43.20B.060 and 1990 c 100 s 7 are each amended to read as follows:
(1)
To secure reimbursement of any assistance paid under chapter 74.09 RCW or
reimbursement for any residential care provided by the department at a hospital
for the mentally ill or habilitative care center for the developmentally
disabled, as a result of injuries to or illness of a recipient caused by the
negligence or wrong of another, the department shall be subrogated to the
recipient's rights against a tort feasor or the tort feasor's insurer, or both.
(2)
The department shall have a lien upon any recovery by or on behalf of the
recipient from such tort feasor or the tort feasor's insurer, or both to the
extent of the value of the assistance paid or residential care provided by the
department, provided that such lien shall not be effective against recoveries
subject to wrongful death when there are surviving dependents of the deceased.
The lien shall become effective upon filing with the county auditor in the
county where the assistance was authorized or where any action is brought against
the tort feasor or insurer. The lien may also be filed in any other county or
served upon the recipient in the same manner as a civil summons if, in the
department's discretion, such alternate filing or service is necessary to
secure the department's interest. The additional lien shall be effective upon
filing or service.
(3)
The lien of the department shall be upon any claim, right of action, settlement
proceeds, money, or benefits arising from an insurance program to which the
recipient might be entitled (a) against the tort feasor or insurer of the tort
feasor, or both, and (b) under any contract of insurance purchased by the
recipient or by any other person providing coverage for the illness or injuries
for which the assistance or residential care is paid or provided by the
department.
(4)
If recovery is made by the department under this section and the subrogation is
fully or partially satisfied through an action brought by or on behalf of the
recipient, the amount paid to the department shall bear its proportionate share
of attorneys' fees and costs.
(a)
The determination of the proportionate share to be borne by the department
shall be based upon:
(((a)))
(i) The fees and costs approved by the court in which the action was
initiated; or
(((b)))
(ii) The written agreement between the attorney and client which
establishes fees and costs when fees and costs are not addressed by the court.
(((c)))
(b) When fees and costs have been approved by a court, after notice to
the department, the department shall have the right to be heard on the matter
of attorneys' fees and costs or its proportionate share.
(((d)))
(c) When fees and costs have not been addressed by the court, the
department shall receive at the time of settlement a copy of the written
agreement between the attorney and client which establishes fees and costs and
may request and examine documentation of fees and costs associated with the
case. The department may bring an action in superior court to void a
settlement if it believes the attorneys' calculation of its proportionate share
of fees and costs is inconsistent with the written agreement between the
attorney and client which establishes fees and costs or if the fees and costs
associated with the case are exorbitant in relation to cases of a similar
nature.
(5)
The rights and remedies provided to the department in this section to secure
reimbursement for assistance, including the department's lien and subrogation
rights, may be delegated to a managed health care system by contract entered
into pursuant to RCW 74.09.522. A managed health care system may enforce all
rights and remedies delegated to it by the department to secure and recover assistance
provided under a managed health care system consistent with its agreement with
the department.
