Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-502A - Program integrity
Section 182-502A-0801 - Dispute resolution process

Universal Citation: WA Admin Code 182-502A-0801

Current through Register Vol. 24-18, September 15, 2024

(1) An entity may informally dispute a preliminary finding. The medicaid agency must receive any request for dispute resolution within thirty calendar days of the date the entity received the preliminary finding. The request for dispute resolution must be in writing and include the following:

(a) The supporting evidence for each disputed preliminary finding; and

(b) The relief sought for each disputed preliminary finding.

(2) The dispute may include a request for a dispute resolution conference (DRC).

(a) If the agency grants the entity's request for a DRC, the DRC occurs within sixty calendar days of the date the entity received the agency's written acceptance of the request for a DRC.

(b) At least five business days before the DRC, the entity must notify the agency of who will attend the DRC on the entity's behalf.

(3) Following the timely submission of a written request for dispute resolution under subsection (1) of this section and completion of any DRC, the agency addresses in writing each written disputed preliminary finding raised by the entity.

(4) The agency may terminate the dispute resolution process and issue a final notice if the entity fails to comply with the requirements of this section.

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