HTML has links - PDF has Authentication
110-15-0267  <<  110-15-0268 >>   110-15-0269

PDFWAC 110-15-0268

Payment discrepanciesProvider overpayments.

(1) An overpayment occurs when providers receive payments that are more than providers are eligible to receive. Provider overpayments may be established when providers:
(a) Bill and receive payments for services not provided;
(b) Bill without attendance records that support the billing. Beginning July 1, 2018, attendance must be recorded using DCYF's electronic attendance system or a DCYF-approved electronic attendance system. Any other format for recording attendance will not be considered valid support for provider billings and may result in overpayments;
(c) Bill and receive payments for more than they are eligible to bill;
(d) Routinely provide care in locations other than what was approved at the time of authorization;
(e) With respect to license-exempt in-home/relative providers, they bill the state for more than six children at one time for the same hours of care; or
(f) With respect to licensed or certified providers, they:
(i) Bill the state for more than the number of children in the provider's licensed capacity; or
(ii) Are caring for children receiving WCCC benefits outside the providers' licensed allowable age range without a DCYF-approved exception; or
(g) With respect to certified providers caring for children in states bordering Washington, they:
(i) Are determined to not be in compliance with the state's licensing regulations; or
(ii) Fail to notify DCYF within 10 days of any suspension, revocation, or change to the provider's license.
(2) DCYF will request documentation from providers when preparing to establish an overpayment. Providers must provide requested information within 45 calendar days from the date of the written request.
(3) Providers may be required to repay any payments that they were not eligible to receive.
(4) Providers may be required to repay overpayments they received, even if they were the result of a DCYF error in issuing payment a provider was not eligible to receive.
[Statutory Authority: RCW 43.216.055 and 43.216.065. WSR 22-05-007, § 110-15-0268, filed 2/3/22, effective 3/6/22. Statutory Authority: RCW 43.216.055, 43.216.065 and 42 U.S.C. 9858, et seq. WSR 19-08-020, § 110-15-0268, filed 3/26/19, effective 4/26/19. WSR 18-14-078, recodified as § 110-15-0268, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 43.215.060, 43.215.070 and 2017 3rd sp.s. c 1 § 615. WSR 17-23-033, § 170-290-0268, filed 11/7/17, effective 12/8/17. Statutory Authority: RCW 43.215.060, 43.215.070, and chapter 43.215 RCW. WSR 17-12-035, § 170-290-0268, filed 5/31/17, effective 7/1/17; WSR 12-11-025, § 170-290-0268, filed 5/8/12, effective 6/8/12. Statutory Authority: RCW 43.215.060, 43.215.070, 2006 c 265, and chapter 43.215 RCW. WSR 09-22-043, § 170-290-0268, filed 10/28/09, effective 12/1/09.]
Site Contents
Selected content listed in alphabetical order under each group