AN
ACT Relating to health services providers under industrial insurance; amending
RCW 51.48.280; adding a new section to chapter 51.36 RCW; and prescribing
penalties.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec.
1. RCW
51.48.280 and 1986 c 200 s 6 are each amended to read as follows:
(1)
Any person, firm, corporation, partnership, association, agency, institution,
or other legal entity, that solicits or receives any remuneration (including
any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in
cash or in kind:
(a)
In return for referring an individual to a person for the furnishing or
arranging for the furnishing of any item or service for which payment may be
made in whole or in part under this chapter; or
(b)
In return for purchasing, leasing, ordering, or arranging for or recommending
purchasing, leasing, or ordering any goods, facility, service, or item for
which payment may be made in whole or in part under this chapter;
shall
be guilty of a class C felony((: PROVIDED, That)). However, the
fine, if imposed, shall not be in an amount more than twenty-five thousand
dollars, except as authorized by RCW 9A.20.030.
(2)
Any person, firm, corporation, partnership, association, agency, institution,
or other legal entity, that offers or pays any remuneration (including any
kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in
cash or in kind to any person to induce such person:
(a)
To refer an individual to a person for the furnishing or arranging for the
furnishing of any item or service for which payment may be made, in whole or in
part, under this chapter; or
(b)
To purchase, lease, order, or arrange for or recommend purchasing, leasing, or
ordering any goods, facility, service, or item for which payment may be made in
whole or in part under this chapter;
shall
be guilty of a class C felony((: PROVIDED, That)). However, the
fine, if imposed, shall not be in an amount more than twenty-five thousand
dollars, except as authorized by RCW 9A.20.030.
(3)
A health services provider who (a) provides a health care service to a
claimant, while acting as the claimant's representative for the purpose of
obtaining authorization for the services, and (b) charges a percentage of the
claimant's benefits or other fee for acting as the claimant's representative
under this title shall be guilty of a gross misdemeanor. However, the fine, if
imposed, shall not be in an amount more than twenty-five thousand dollars,
except as authorized by RCW 9A.20.030.
(4)
Subsections (1) and (2) of this section shall not apply to:
(a)
A discount or other reduction in price obtained by a provider of services or
other entity under this chapter if the reduction in price is properly disclosed
and appropriately reflected in the costs claimed or charges made by the
provider or entity under this chapter; and
(b)
Any amount paid by an employer to an employee (who has a bona fide employment
relationship with such employer) for employment in the provision of covered
items or services.
(((4)))
(5) Subsections (1) and (2) of this section, if applicable to the
conduct involved, shall supersede the criminal provisions of chapter 19.68 RCW,
but shall not preclude administrative proceedings authorized by chapter 19.68
RCW.
NEW
SECTION. Sec. 2. A
new section is added to chapter 51.36 RCW to read as follows:
In
addition to other authority granted under this chapter, the department may deny
applications of health care providers to participate as a provider of services
to injured workers under this title, or terminate or suspend providers'
eligibility to participate, if the provider uses or causes or promotes the use
of, advertising matter, promotional materials, or other representation, however
disseminated or published, that is false, misleading, or deceptive with respect
to the industrial insurance system or benefits for injured workers under this
title.
