For the purposes of this section, the term "agency" includes the agency's designee.
(1) When the agency may file.
(a) The agency may file a lien against the property of a Washington apple health client during the client's lifetime if:
(i) The client resides in a skilled nursing facility, intermediate care facility for individuals with an intellectual disability, or other medical institution under WAC
182-500-0050;
(ii) The agency determines that a client cannot reasonably be expected to return home because:
(A) The agency receives a physician's verification that the client will not be able to return home; or
(B) The client has resided for six months or longer in an institution as defined in WAC
182-500-0050; and
(iii) None of the following people lawfully reside in the client's home:
(A) The client's spouse or state-registered domestic partner;
(B) The client's child who is age twenty or younger, or is blind or permanently disabled as defined in WAC
182-512-0050; or
(C) A client's sibling who has an equity interest in the home and who has been residing in the home for at least one year immediately before the client's admission to the medical institution.
(b) If the client returns home from the medical institution, the agency releases the lien.
(2) Amount of the lien.
(a) The agency may file a lien to recoup the cost of all non-MAGI-based and deemed eligible services under WAC
182-503-0510 it correctly purchased on the client's behalf, regardless of the client's age on the date of service.
(b) Services provided under the medicaid transformation project, defined in WAC
182-500-0070, are excluded when determining the amount of the lien.
(3) Notice requirement.
(a) Before the agency may file a lien under this section, it sends notice via first class mail to:
(i) The client's last known address;
(ii) The client's authorized representative, if any;
(iii) The address of the property subject to the lien; and
(iv) Any other person known to hold title to the property.
(b) The notice states:
(i) The client's name;
(ii) The agency's intent to file a lien against the client's property;
(iii) The county in which the property is located; and
(iv) How to request an administrative hearing.
(4) Interest assessed on past-due debt.
(a) Interest on a past-due debt accrues at a rate of one percent per month under RCW
43.17.240.
(b) A lien under this section becomes a past-due debt when the agency has recorded the lien in the county where the property is located and:
(i) Thirty days have passed since the property was transferred; or
(ii) Nine months have passed since the lien was filed.
(c) The agency may waive interest if reasonable efforts to sell the property have failed.
(5)
Administrative hearing. An administrative hearing under this section is governed by WAC
182-527-2753.
[Statutory Authority: RCW
41.05.021 and
41.05.160, 2016 1st sp.s. c 36 § 213 (1)(e), section 1115 of the Social Security Act, and 42 C.F.R. §§ 431.400 through 431.428. WSR 17-12-019, § 182-527-2734, filed 5/30/17, effective 7/1/17. Statutory Authority: RCW
41.05.021,
41.05.160. WSR 16-05-054, § 182-527-2734, filed 2/12/16, effective 3/14/16.]
