HEALTH CARE AUTHORITY
[Filed March 3, 2021, 10:17 a.m.]
Preproposal statement of inquiry was filed as WSR 20-24-086.
Title of Rule and Other Identifying Information: WAC 182-543-2200 Proof of delivery.
Hearing Location(s): On April 6, 2021, at 10:00 a.m. In response to the coronavirus disease 2019 (COVID-19) public health emergency, the agency will not provide a physical location for this hearing. This promotes social distancing and the safety of the citizens of Washington state. A virtual public hearing, without a physical meeting space, will be held instead. To attend the virtual public hearing, you must register at the following link https://attendee.gotowebinar.com/register/1443618498460852747, Webinar ID 560-087-099. After registering, you will receive a confirmation email containing the information about joining the webinar.
Date of Intended Adoption: Not sooner than April 7, 2021.
Submit Written Comments to: Health Care Authority (HCA), Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email firstname.lastname@example.org, fax 360-586-9727, by April 6, 2021.
Assistance for Persons with Disabilities: Contact Amber Lougheed, phone 360-725-1349, fax 360-586-9727, telecommunication[s] relay services 711, email email@example.com, by March 19, 2021.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: HCA is revising this section to eliminate the requirement for date and signature from the medicaid client or the client's designee upon delivery of medical equipment and supplies in order to avoid contact between the client and delivery person. HCA currently has emergency rules, filed under WSR 20-23-038, striking this requirement. Once the public health emergency ends, the agency will conduct rule making to add this requirement back into the rule.
Reasons Supporting Proposal: See purpose.
Rule is not necessitated by federal law, federal or state court decision.
Agency Comments or Recommendations, if any, as to Statutory Language, Implementation, Enforcement, and Fiscal Matters: Not applicable.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Valerie Freudenstein, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1344; Implementation and Enforcement: Erin Mayo, P.O. Box 45506, Olympia, WA 98504-5506, 360-725-1729.
A school district fiscal impact statement is not required under RCW 28A.305.135
A cost-benefit analysis is not required under RCW 34.05.328
. RCW 34.05.328
does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The proposed rule does not impose any costs on businesses.
March 3, 2021
AMENDATORY SECTION(Amending WSR 18-24-021, filed 11/27/18, effective 1/1/19)
WAC 182-543-2200Proof of delivery.
(1) When a provider delivers an item directly to the client or the client's authorized representative, the provider must furnish the proof of delivery when the medicaid agency requests that information. All of the following apply:
(a) The agency requires a delivery slip as proof of delivery. The proof of delivery slip must:
(i) ((Be signed and dated by the client or the client's authorized representative (the date of signature must be the date the item was received by the client);
(ii))) Include the client's name and a detailed description of the item(s) delivered, including the quantity and brand name; and
(((iii)))(ii) For medical equipment that may require future repairs, include the serial number.
(b) When the provider or supplier submits a claim for payment to the agency, the date of service on the claim must be one of the following:
(i) For a one-time delivery, the date the item was received by the client or the client's authorized representative; or
(ii) For nondurable medical supplies for which the agency has established a monthly maximum, on or after the date the item was received by the client or the client's authorized representative.
(2) When a provider uses a delivery/shipping service to deliver items which are not fitted to the client, the provider must furnish proof of delivery that the client received the equipment and/or supply, when the agency requests that information.
(a) If the provider uses a delivery/shipping service, the tracking slip is the proof of delivery. The tracking slip must include:
(i) The client's name or a reference to the client's package or packages;
(ii) The delivery service package identification number; and
(iii) The delivery address.
(b) If the provider/supplier does the delivering, the delivery slip is the proof of delivery. The delivery slip must include:
(i) The client's name;
(ii) The shipping service package identification number;
(iii) The quantity, detailed description(s), and brand name or names of the items being shipped; and
(iv) For medical equipment that may require future repairs, the serial number.
(c) When billing the agency, use:
(i) The shipping date as the date of service on the claim if the provider uses a delivery/shipping service; or
(ii) The actual date of delivery as the date of service on the claim if the provider/supplier does the delivery.
(3) A provider must not use a delivery/shipping service to deliver items which must be fitted to the client.
(4) Providers must obtain prior authorization when required before delivering the item to the client. The item must be delivered to the client before the provider bills the agency.
(5) The agency does not pay for medical equipment and related items furnished to the agency's clients when:
(a) The medical professional who provides medical justification to the agency for the item provided to the client is an employee of, has a contract with, or has any financial relationship with the provider of the item; or
(b) The medical professional who performs a client evaluation is an employee of, has a contract with, or has any financial relationship with a provider of medical equipment and related items.