Section 182-551-1530 - Payment method for medicaid-medicare dual eligible clients(1) The medicaid agency will not pay the portion of hospice care for a client that is covered under medicare part A. Nursing home room and board charges described in WAC 182-551-1510 that are not covered under medicare part A may be covered by the medicaid agency.(2) The medicaid agency may pay for hospice care provided to a client: (a) Covered by medicaid part B (medical insurance); and(b) Not covered by medicare part A.(3) For hospice care provided to a medicaid-medicare dual eligible client, hospice agencies are responsible to bill: (a) Medicare before billing the medicaid agency;(b) The medicaid agency for hospice nursing facility room and board;(c) The medicaid agency for hospice care center room and board; and(d) Medicare for general inpatient care or inpatient respite care.(4) All the limitations and requirements related to hospice care described in subchapter I apply to the payments described in this section.Wash. Admin. Code § 182-551-1530
Amended by WSR 16-03-035, Filed 1/12/2016, effective 2/12/2016Statutory Authority: RCW 41.05.021, Section 2302 of the Patient Protection and Affordable Care Act of 2010 ( P.L. 111-148), and Section 1814(a)(7) of the Social Security Act. 12-09-079, §182-551-1530, filed 4/17/12, effective 5/18/12. 11-14-075, recodified as §182-551-1530, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.520. 05-18-033, § 388-551-1530, filed 8/30/05, effective 10/1/05. Statutory Authority: RCW 74.09.520 and 74.08.090, 42 C.F.R. 418.22 and 418.24. 99-09-007, § 388-551-1530, filed 4/9/99, effective 5/10/99.