Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-540 - Kidney disease program and kidney center services
KIDNEY DISEASE PROGRAM (STATE-FUNDED)
Section 182-540-065 - Kidney disease program (KDP) - Reimbursement

Universal Citation: WA Admin Code 182-540-065

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

(1) The agency reimburses KDP contractors:

(a) Within the limits of legislative funding for the program;

(b) According to the terms of each kidney center's contract with the agency; and

(c) According to the provisions of the KDP manual.

(2) The KDP contractor must submit the following documentation to the agency's KDP program manager within the time limits specified within the KDP contract:

(a) A description of the services for which reimbursement is requested; and

(b)

The person's approved KDP application if the application had not previously been provided to the KDP program manager.

(3) A KDP client is not liable and must not be billed for charges incurred under KDP due to the failure of the KDP contractor to bill the agency within the time limits specified in the contract.

(4) The agency limits KDP reimbursement for out-of-state services to fourteen days per calendar year. Reimbursement is paid only to KDP contractors. Out-of-state dialysis providers must operate under subcontract or agreement with an in-state KDP contractor in order to receive reimbursement under this program.

Statutory Authority: 11-14-075, recodified as §182-540-065, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.510, 74.09.520, 74.09.522, and 42 C.F.R. 405.2101. WSR 03-21-039, § 388-540-065, filed 10/8/03, effective 11/8/03. WSR 13-23-007, §182-540-065, filed 11/7/2013, effective 12/8/2013

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