Wash. Admin. Code § 182-502-0050 - Provider dispute of an agency action

Current through Register Vol. 21-24, December 15, 2021

The process described in this section applies only when department rules allow a provider to dispute a department decision under this section.

(1) In order for the department to review a decision previously made by the department, a provider must submit the request to review the decision:
(a) Within twenty-eight calendar days of the date on the department's decision notice;
(b) To the address listed in the decision notice; and
(c) In a manner that provides proof of receipt.
(2) A provider's dispute request must:
(a) Be in writing;
(b) Specify the department decision that the provider is disputing;
(c) State the basis for disputing the department's decision; and
(d) Include documentation to support the provider's position.
(3) The department may request additional information or documentation. The provider must submit the additional information or documentation to the department within twenty-eight calendar days of the date on the department's request.
(4) The department closes the dispute without issuing a decision and with no right to further review under subsection (6) of this section when the provider:
(a) Fails to comply with any requirement of subsections (2), (3), and (4) of this section;
(b) Fails to cooperate with, or unduly delays, the dispute process; or
(c) Withdraws the dispute request in writing.
(5) The department will send the provider a written notice of dispute closure or written dispute decision.
(6) The provider may request the deputy assistant secretary of the medicaid purchasing administration (MPA) or designee to review the written dispute decision according to the process in WAC 388-502-0270.
(7) This section does not apply to disputes regarding overpayment. For disputes regarding overpayment, see WAC 388-502-0230.


Wash. Admin. Code § 182-502-0050

WSR 11-14-075, recodified as § 182-502-0050, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.080, and 74.09.290. WSR 11-11-017, § 388-502-0050, filed 5/9/11, effective 6/9/11.

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