WAC 388-527-2742   Services subject to recovery.  The department considers the medical services the client received and the dates when the services were provided to the client, in order to determine whether the client's estate is liable for the cost of medical services provided. Subsection (1) of this section covers liability for medicaid services and subsection (2) covers liability for state-only funded long-term care services. An estate can be liable under both subsections.

     (1) The client's estate is liable for:

     (a) All medicaid services provided from July 26, 1987 through June 30, 1994;

     (b) The following medicaid services provided after June 30, 1994 and before July 1, 1995:

     (i) Nursing facility services;

     (ii) Home and community-based services; and

     (iii) Hospital and prescription drug services provided to a client while receiving nursing facility services or home and community-based services.

     (c) The following medicaid services provided after June 30, 1995 and before June 1, 2004:

     (i) Nursing facility services;

     (ii) Home and community-based services;

     (iii) Adult day health;

     (iv) Medicaid personal care;

     (v) Private duty nursing administered by the aging and disability services administration of the department; and

     (vi) Hospital and prescription drug services provided to a client while receiving services described under (c)(i), (ii), (iii), (iv), or (v) of this subsection.

     (d) The following services provided on and after June 1, 2004:

     (i) All medicaid services;

     (ii) Medicare savings programs services for individuals also receiving medicaid;

     (iii) Medicare premiums only for individuals also receiving medicaid; and

     (iv) Premium payments to managed care organizations.

     (2) The client's estate is liable for all state-only funded long-term care services and related hospital and prescription drug services provided to:

     (a) Home and community services' clients on and after July 1, 1995; and

     (b) Division of developmental disabilities' clients on and after June 1, 2004.



[Statutory Authority: 2005 c 292, RCW 43.20B.080, 74.39A.170, 42 U.S.C. Section 1396p. 06-17-075, § 388-527-2742, filed 8/14/06, effective 9/14/06. Statutory Authority: RCW 43.17.240, 43.20B.80 [43.20B.080], 74.08.090, 74.34.090, Section 1917(b) of the Social Security Act and 2001 2nd sp.s. c 7, Part II. 04-10-060, § 388-527-2742, filed 4/30/04, effective 6/1/04. Statutory Authority: RCW 43.20B.080, 74.08.090 and 74.34.010. 99-11-076, § 388-527-2742, filed 5/18/99, effective 6/18/99. Statutory Authority: RCW 74.08.090 and 1995 1st sp.s. c 18. 95-19-001 (Order 3893), § 388-527-2742, filed 9/6/95, effective 10/7/95.]