WSR 99-19-023

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Economic Services Administration)

(Division of Assistance Programs)

[ Filed September 7, 1999, 3:34 p.m. ]

Original Notice.

Exempt from preproposal statement of inquiry under RCW 34.05.310(4).

Title of Rule: WAC 388-410-0001 Cash/medical assistance overpayment.

Purpose: Ensure WAC 388-410-0001 conforms to RCW 74.08.080 (2)(e) which limits client's overpayment liability when cash assistance is recovered pending a fair hearing.

Statutory Authority for Adoption: RCW 74.04.510.

Statute Being Implemented: RCW 74.08.080 (2)(e), 74.04.510.

Summary: When the department is upheld in a fair hearing, the department may only establish an overpayment for up to sixty days after the department receives the client's hearing request.

Reasons Supporting Proposal: RCW 74.08.080 (2)(e) requires this change.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Joan Wirth, 1009 College Street S.E., Lacey, WA, (360) 413-3073.

Name of Proponent: Department of Social and Health Services, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: When the department is upheld in a fair hearing, the department may only establish an overpayment for up to sixty days after the department received the client's fair hearing request.

Proposal Changes the Following Existing Rules: WAC 388-410-0001 limits client's overpayment when assistance is continued pending a fair hearing and the department is upheld in the fair hearing.

No small business economic impact statement has been prepared under chapter 19.85 RCW. This rule affects cash/medical assistance recipients only.

RCW 34.05.328 does not apply to this rule adoption. This is not a significant legislative rule.

Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on October 26, 1999, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Paige Wall by October 12, 1999, phone (360) 664-6094, TTY (360) 664-6178, e-mail wallpg@dshs.wa.gov.

Submit Written Comments to: Identify WAC Numbers, Paige Wall, Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, by October 26, 1999.

Date of Intended Adoption: December 1, 1999.

September 2, 1999

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit

2632.3
AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-410-0001
What is a cash/medical assistance overpayment((s.))?

(1) An overpayment ((means)) is any cash or medical assistance paid ((to an)) that is more than the assistance unit ((where:

(a) Eligibility for the payment did not exist; or

(b) Assistance paid was in excess of need)) was eligible to receive.

(2) There are two ((different)) types of cash/medical overpayments ((for cash and medical assistance)):

(a) Intentional overpayments((; and

(b) Unintentional overpayments.

(3) The client is presumed to have committed an intentional overpayment when the client willfully or knowingly:

(a))), presumed to exist when the client willfully or knowingly:

(i) Fails to report within twenty days a change in circumstances that affects ((the client's)) eligibility ((or need)); or

(((b))) (ii) Misstates or fails to reveal a ((material fact that affects)) fact affecting eligibility ((or need)) as specified in WAC 388-446-0001.

(((4) All overpayments that are not due to the willful or knowing failure of the client to provide information necessary to determine eligibility are considered unintentional overpayments.

(5) Child support payments received directly from the absent parent are not treated as a grant overpayment if kept by the caretaker relative.  Such payments are considered a debt to the division of child support))

(b) Unintentional overpayments, which includes all other client-caused overpayments.

(3) If the client requests a fair hearing and the department's decision is upheld, then:

(a) The continued assistance, pending the fair hearing, becomes an overpayment to the client (see WAC 388-418-0030); and

(b) The department may establish an overpayment for no more than sixty days after the department receives the client's hearing request.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, § 388-410-0001, filed 7/31/98, effective 9/1/98.]

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