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110-50-1070  <<  110-50-1080 >>   110-50-1090

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WAC 110-50-1080

Caregiver reimbursement program claim denials.

The department:
(1) Will:
(a) Deny caregiver reimbursement program claims:
(i) That are not supported or substantiated by the evidence submitted;
(ii) For items or amounts not covered or excluded by the terms, limitations, or exclusions of the caregiver reimbursement program;
(iii) For ineligible placements; or
(iv) When the property damages, property loss, or emergency medical expenses are misrepresented or willfully concealed by caregivers or other parties involved; and
(b) Report caregiver reimbursement program claims found to be fraudulent or involving theft or collusion involving public funds per RCW 43.09.185; and
(2) May:
(a) Recover payments made for caregiver reimbursement program claims that were determined to be ineligible; or
(b) Refer caregiver reimbursement program claims found to be fraudulent involving theft or collusion involving public funds to the assistant attorney general and local law enforcement.
[Statutory Authority: RCW 74.13.031 and 74.13.335. WSR 26-09-128, s 110-50-1080, filed 4/21/26, effective 5/22/26. WSR 18-14-078, recodified as § 110-50-1080, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 74.13.031. WSR 01-08-047, § 388-25-0380, filed 3/30/01, effective 4/30/01.]