Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-502A - Program integrity
Section 182-502A-0901 - Administrative hearing (formal appeal) right

Universal Citation: WA Admin Code 182-502A-0901

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

(1) An entity has a right to an administrative hearing (formal appeal), and any resulting appeals process under RCW 41.05A.170 and chapter 182-526 WAC, if the agency assesses an overpayment against the entity.

(2) An entity does not have an administrative hearing right for the denial of payment of a claim.

(3) At the administrative hearing and on appeal, the entity bears the burden of proving by a preponderance of the evidence that it has complied with applicable laws, rules, regulations, and agreements.

(4) The administrative hearing process is governed by chapter 34.05 RCW and chapter 182-526 WAC.

(5) The medicaid agency does not recoup overpayments until a decision in the administrative hearing is issued and all appeals, if any, have been exhausted.

(6) Interest on overpayments continues to accrue, but it is not collected until a decision in the administrative hearing is issued and all appeals, if any, have been exhausted. See RCW 74.09.220.

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