(1) When you become eligible for any of the
agency's health care programs, you assign certain rights to the state of
Washington. You assign all rights to any type of coverage or payment for health
care that comes from:
(a) A court
order;
(b) An administrative agency
order; or
(c) Any third-party
benefits or payment obligations for medical care which are the result of
subrogation or contract (see WAC
182-501-0100
).
(2) When you sign the
application you assign the rights described in subsection (1) of this section
to the state for:
(a) Yourself; and
(b) Any eligible person for whom you can
legally make such assignment.
(3) You must cooperate with us in
identifying, using or collecting third-party benefits. If you do not cooperate,
your health care coverage may end unless you can show good reason not to
cooperate with us. Examples of good reason include, but are not limited to:
(a) Your reasonable belief that cooperating
with us would result in serious physical or emotional harm to you, a child in
your care, or a child related to you; and
(b) Your being incapacitated without the
ability to cooperate with us.
(4) Your WAH coverage will not end due solely
to the noncooperation of any third party.
(5) You will have to pay for your health care
services if you:
(a) Received and kept the
third-party payment for those services; or
(b) Refused to give to the provider of care
your legal signature on insurance forms.
(6) The state is limited to the recovery of
its own costs for health care costs paid on behalf of a recipient of health
care coverage. The legal term which describes the method by which the state
acquires the rights of a person for whom the state has paid costs is called
subrogation.
Notes
Wash. Admin.
Code §
182-503-0540
Amended by
WSR
14-16-052, Filed 7/29/2014, effective
8/29/2014
Amended by
WSR
19-02-046, Filed 12/27/2018, effective
1/27/2019
12-13-056, recodified as WAC 182-503-0540, filed 6/15/12,
effective 7/1/12. Statutory Authority:
RCW
74.08.090. 01-02-076, § 388-505-0540, filed
12/29/00, effective 1/29/01. Statutory Authority:
RCW
74.04.050,
74.04.055,
74.04.057 and
74.08.090. 98-16-044, §
388-505-0540, filed 7/31/98, effective 9/1/98. Statutory Authority:
RCW
74.08.090 and
74.09.522. 97-04-005, §
388-505-0540, filed 1/24/97, effective 2/24/97. Statutory Authority:
RCW
74.08.090. 94-10-065 (Order 3732), §
388-505-0540, filed 5/3/94, effective 6/3/94. Formerly WAC 388-83-012,
388-501-0170 and 388-505-0560.
