Purpose: WAC 296-30-090 What are the maximum allowable fees?, is being amended to clarify that the Department of Labor and Industries will establish the reimbursement rates for the crime victims' compensation program.

     Reasons supporting proposal: RCW 7.68.015 requires the Department of Labor and Industries to operate the crime victims' compensation program within the appropriations and the conditions and limitations on the appropriations provided for this program. RCW 7.68.090(b) [RCW 7.68.080 (2)(b)] authorizes the director to set service levels and fees at a level no lower than those established by the Department of [Social and Health Services].

     Citation of Existing Rules Affected by this Order: WAC 296-30-090.

     Statutory Authority for Adoption: RCW 7.68.030.

      Adopted under notice filed as WSR 05-12-114 on May 31, 2005.

     A final cost-benefit analysis is available by contacting Janice Deal, P.O. Box 44520, Olympia, WA 98504-4520, phone (360) 902-5369, fax (360) 902-5333, e-mail deal235@lni.wa.gov.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 1, Amended [1], Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended [1], Repealed 0.

     Date Adopted: August 2, 2005.

Gary Weeks

Director

OTS-8099.1

AMENDATORY SECTION(Amending WSR 00-03-056, filed 1/14/00, effective 2/14/00)

WAC 296-30-090   What are the maximum allowable fees?   (1) Maximum allowable fees for medical and mental health services are those fees ((published in the Medical Aid Rules and Fee Schedules)) established by the department of labor and industries for the crime victims compensation program, less any available benefits of public or private insurance.

     (((2) Maximum allowable fees for mental health services are those fees published in the Crime Victims Compensation Program Mental Health Treatment Rules and Fees less any available benefits of public or private insurance.))

EXCEPTION:

If any of the maximum allowable fees ((in the publications entitled Medical Aid Rules and Fee Schedules and Crime Victims Compensation Program Mental Health Treatment Rules and Fees)) established by the department of labor and industries for the crime victims compensation program, are lower than the maximum allowable fees for those procedures established by the department of social and health services under Title 74 RCW, the Title 74 RCW fees are the maximum allowable fees for those procedures.

     (((3))) (2) The percent of allowed charges authorized for hospital inpatient and outpatient services billed by revenue codes are those rates established by the department of social and health services under Title 74 RCW and WAC 388-550-4500 (1)(a) and 388-550-6000 (1)(a) less any available benefits of public or private insurance.

[Statutory Authority: RCW 7.68.030, 7.68.080, 7.68.130. 00-03-056, § 296-30-090, filed 1/14/00, effective 2/14/00.]

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