388-71-0540  <<  388-71-0543 >>   388-71-0544

WAC 388-71-0543

When may the department, AAA, or department designee deny payment for the services of an individual provider?

In addition to mandatory denials of payment under WAC 388-71-0540, the department, AAA, or department designee may deny payment for the services of an individual provider who:
(1) Has been convicted of:
(a) Any crime that the department determines is reasonably related to the competency of the person to provide care to a client; or
(b) A crime involving a firearm used in commission of a felony or in any act of violence against a person.
(2) Is engaged in the misuse of alcohol, controlled substances, or legend drugs;
(3) Has committed an act of domestic violence toward a family or household member;
(4) Has been found in any final decision of a federal or state agency to have abandoned, neglected, abused or financially exploited a vulnerable adult, unless the department is required to deny payment under WAC 388-71-0540;
(5) Has had a license for the care of children or vulnerable adults denied, suspended, revoked, terminated, or not renewed unless the department is required to deny payment under WAC 388-71-0540;
(6) Has had any health care provider license, certification or contract denied, suspended, revoked, terminated, even though the license was later reinstated after satisfactory completion of conditions or other requirements. This provision also applies to a long-term care worker who voluntarily relinquished a license, certification or contract in lieu of revocation or termination;
(7) Has had any residential care facility or health care facility license, certification, contract denied, suspended, revoked, terminated, even though the license, certification or contract was later reinstated after satisfactory completion of conditions or other requirements. This provision also applies to a long-term care worker who voluntarily relinquished a license, certification or contract in lieu of revocation or termination;
(8) Has been enjoined from operating a facility for the care and services of children or adults; or
(9) Has been the subject of a sanction or corrective or remedial action taken by federal, state, county, or municipal officials or safety officials related to the care or treatment of children or vulnerable adults, unless the department is required to deny payment under WAC 388-71-0540.
[Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, ยง 388-71-0543, filed 12/20/12, effective 1/20/13.]
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