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182-502-0040  <<  182-502-0050 >>   182-502-0060

PDFWAC 182-502-0050

Provider dispute of an agency action.

The process described in this section applies only when agency rules allow a provider to dispute an agency decision under this section.
(1) In order for the agency to review a decision previously made by the agency, a provider must submit the request to review the decision:
(a) Within twenty-eight calendar days of the date on the agency'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 agency decision that the provider is disputing;
(c) State the basis for disputing the agency's decision; and
(d) Include documentation to support the provider's position.
(3) The agency may request additional information or documentation. The provider must submit the additional information or documentation to the agency within twenty-eight calendar days of the date on the agency's request.
(4) The agency 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 agency will send the provider a written notice of dispute closure or written dispute decision.
(6) The provider may request the director of the health care authority or designee to review the written dispute decision according to the process in WAC 182-502-0270.
(7) This section does not apply to disputes regarding overpayment. For disputes regarding overpayment, see WAC 182-502-0230.
[Statutory Authority: RCW 41.05.021. WSR 13-17-047, § 182-502-0050, filed 8/13/13, effective 10/1/13. 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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