Revised Code of Washington
Chapter 43.20B - Revenue Recovery for Department of Social and Health Services.
43.20B.080 - Recovery for paid medical assistance—Rules—Disclosure of estate recovery costs, terms, and conditions.

RCW 43.20B.080
Recovery for paid medical assistance—Rules—Disclosure of estate recovery costs, terms, and conditions.

(1) The department shall file liens, seek adjustment, or otherwise effect recovery for medical assistance correctly paid on behalf of an individual consistent with 42 U.S.C. Sec. 1396p. The department shall adopt a rule providing for prior notice and hearing rights to the record title holder or purchaser under a land sale contract.
(2) Liens may be adjusted by foreclosure in accordance with chapter 61.12 RCW.
(3) In the case of an individual who was fifty-five years of age or older when the individual received medical assistance, the department shall seek adjustment or recovery from the individual's estate, and from nonprobate assets of the individual as defined by RCW 11.02.005, but only for medical assistance consisting of nursing facility services, home and community-based services, other services that the department determines to be appropriate, and related hospital and prescription drug services. Recovery from the individual's estate, including foreclosure of liens imposed under this section, shall be undertaken as soon as practicable, consistent with 42 U.S.C. Sec. 1396p.
(4) The department shall apply the medical assistance estate recovery law as it existed on the date that benefits were received when calculating an estate's liability to reimburse the department for those benefits.
(5)(a) The department shall establish procedures consistent with standards established by the federal department of health and human services and pursuant to 42 U.S.C. Sec. 1396p to waive recovery when such recovery would work an undue hardship. The department shall recognize an undue hardship for a surviving domestic partner whenever recovery would not have been permitted if he or she had been a surviving spouse. The department is not authorized to pursue recovery under such circumstances.
(b) Recovery of medical assistance from a recipient's estate shall not include property made exempt from claims by federal law or treaty, including exemption for tribal artifacts that may be held by individual Native Americans.
(6) A lien authorized under this section relates back to attach to any real property that the decedent had an ownership interest in immediately before death and is effective as of that date or date of recording, whichever is earlier.
(7) The department may enforce a lien authorized under this section against a decedent's life estate or joint tenancy interest in real property held by the decedent immediately prior to his or her death. Such a lien enforced under this subsection shall not end and shall continue as provided in this subsection until the department's lien has been satisfied.
(a) The value of the life estate subject to the lien shall be the value of the decedent's interest in the property subject to the life estate immediately prior to the decedent's death.
(b) The value of the joint tenancy interest subject to the lien shall be the value of the decedent's fractional interest the recipient would have owned in the jointly held interest in the property had the recipient and the surviving joint tenants held title to the property as tenants in common on the date of the recipient's death.
(c) The department may not enforce the lien provided by this subsection against a bona fide purchaser or encumbrancer that obtains an interest in the property after the death of the recipient and before the department records either its lien or the request for notice of transfer or encumbrance as provided by RCW 43.20B.750.
(d) The department may not enforce a lien provided by this subsection against any property right that vested prior to July 1, 2005.
(8)(a) Subject to the requirements of 42 U.S.C. Sec. 1396p(a) and the conditions of this subsection (8), the department is authorized to file a lien against the property of an individual prior to his or her death, and to seek adjustment and recovery from the individual's estate or sale of the property subject to the lien, if:
(i) The individual is an inpatient in a nursing facility, intermediate care facility for persons with intellectual disabilities, or other medical institution; and
(ii) The department has determined after notice and opportunity for a hearing that the individual cannot reasonably be expected to be discharged from the medical institution and to return home.
(b) If the individual is discharged from the medical facility and returns home, the department shall dissolve the lien.
(9) The department is authorized to adopt rules to effect recovery under this section. The department may adopt by rule later enactments of the federal laws referenced in this section.
(10) It is the responsibility of the department to fully disclose in advance verbally and in writing, in easy to understand language, the terms and conditions of estate recovery to all persons offered long-term care services subject to recovery of payments.
(11) In disclosing estate recovery costs to potential clients, and to family members at the consent of the client, the department shall provide a written description of the community service options.

[ 2010 c 94 § 12; 2008 c 6 § 302; 2005 c 292 § 6; 1999 c 354 § 2; 1997 c 392 § 302; 1995 1st sp.s. c 18 § 67; 1994 c 21 § 3.]
NOTES:

Purpose—2010 c 94: See note following RCW 44.04.280.


Part headings not law—Severability—2008 c 6: See RCW 26.60.900 and 26.60.901.


Short title—Findings—Construction—Conflict with federal requirements—Part headings and captions not law—1997 c 392: See notes following RCW 74.39A.009.


Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.


Conflict with federal requirements—1994 c 21: "If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not affect the operation of the remainder of this act in its application to the agencies concerned. The rules under this act shall meet federal requirements that are a necessary condition to the receipt of federal funds by the state." [ 1994 c 21 § 5.]


Effective date—1994 c 21: "This act shall take effect July 1, 1994." [ 1994 c 21 § 6.]


Legislative confirmation of effect of 1994 c 21: RCW 43.20B.090.

Structure Revised Code of Washington

Revised Code of Washington

Title 43 - State Government—Executive

Chapter 43.20B - Revenue Recovery for Department of Social and Health Services.

43.20B.010 - Definitions.

43.20B.020 - Fees for services—Department of health and department of social and health services.

43.20B.030 - Overpayments and debts due the department—Time limit—Write-offs and compromises—Waivers.

43.20B.040 - Chapter does not apply where another party liable—Statement of lien—Form.

43.20B.050 - Liens—Compromise—Settlement or judgment.

43.20B.060 - Reimbursement for medical care or residential care—Lien—Subrogation—Delegation of lien and subrogation rights.

43.20B.070 - Torts committed against recipients of state assistance—Duties of attorney representing recipient—Trust account for departmental lien.

43.20B.080 - Recovery for paid medical assistance—Rules—Disclosure of estate recovery costs, terms, and conditions.

43.20B.090 - Recovery for paid medical assistance and state-funded long-term care—Legislative intent—Legislative confirmation of effect of 1994 c 21.

43.20B.095 - Establishment and recovery of debts for the department of children, youth, and families.

43.20B.110 - License fees to be charged by secretary—Waiver—Review and comment.

43.20B.120 - Funeral assistance—Lien against assets.

43.20B.310 - Residential care payments by families, when not collected.

43.20B.320 - Mental illness—Treatment costs—Criminally insane—Liability.

43.20B.325 - Mental illness—Hospitalization charges—How computed.

43.20B.330 - Mental illness—Treatment costs—Liability.

43.20B.335 - Mental illness—Treatment costs—Determination of ability to pay—Standards—Rules and regulations.

43.20B.340 - Mental illness—Treatment costs—Notice and finding of responsibility—Period—Adjudicative proceedings.

43.20B.345 - Mental illness—Treatment costs—Judgment for accrued amounts.

43.20B.347 - Mental illness—Treatment costs—Lien against real and personal property.

43.20B.350 - Mental illness—Treatment costs—Modification or vacation of findings of responsibility.

43.20B.355 - Mental illness—Hospitalization charges—Due date—Collection.

43.20B.360 - Mental illness—Hospitalization charges—Collection—Statutes of limitation.

43.20B.370 - Mental illness—Hospitalization charges—Collection—Prosecuting attorneys to assist.

43.20B.410 - Residential habilitation centers—Liability for costs of services—Declaration of purpose.

43.20B.415 - State residential schools—Liability for costs of services—Limitation.

43.20B.420 - Residential habilitation centers—Determination of costs of services—Establishment of rates—Collection.

43.20B.425 - Residential habilitation centers—Costs of services—Investigation and determination of ability to pay—Exemptions.

43.20B.430 - Residential habilitation centers—Costs of services—Initial notice and finding of responsibility—Service—Adjudicative proceeding.

43.20B.435 - State residential habilitation centers—Costs of services—Modification or vacation of initial finding of responsibility.

43.20B.440 - Residential habilitation centers—Costs of services—Charges payable in advance.

43.20B.445 - Residential habilitation centers—Costs of services—Reimbursement from property subsequently acquired—Placement outside school—Liability after death of resident.

43.20B.450 - State residential habilitation centers—Costs of services—Liabilities created apply to care, support, and treatment after July 1, 1967.

43.20B.455 - Residential habilitation centers—Costs of services—Discretionary allowance in resident's fund.

43.20B.460 - Guardianship fees and additional costs for incapacitated clients paying part of costs—Maximum amount—Rules.

43.20B.620 - Overpayments of assistance—Lien against recipient's property—Recovery methods.

43.20B.630 - Overpayments of assistance—Procedures—Adjudicative proceeding.

43.20B.635 - Overpayments of assistance—Orders to withhold property of debtor—Procedures.

43.20B.640 - Overpayments of assistance—Failure to withhold property of debtor.

43.20B.645 - Overpayments of assistance—Assignment of earnings.

43.20B.660 - Improper realty transfer—Suit to rescind—Recovery from recipient's estate.

43.20B.670 - Excess property assistance program—Lien—Department as creditor.

43.20B.675 - Vendor overpayments—Goods or services provided on or after July 1, 1998—Notice—Adjudicative proceeding—Enforcement—Collection—Rules.

43.20B.680 - Vendor overpayments—Lien or other security—Setoff or recoupment—Exception.

43.20B.685 - Vendor overpayments—Liens—Duration—Enforcement.

43.20B.688 - Limitation on actions to enforce vendor overpayment debts.

43.20B.690 - Vendor overpayments—Remedies nonexclusive.

43.20B.695 - Vendor overpayments—Interest—Exceptions.

43.20B.710 - Medical assistance—Improper transfer or assignment of resources—Penalty—Presumption, rebuttal—Attorney's fees.

43.20B.720 - Recipient receiving industrial insurance compensation—Subrogation rights of department—Lien—Withhold and deliver notice.

43.20B.730 - Recipient receiving industrial insurance compensation—Effective date of lien and notice—Service.

43.20B.735 - Recipient receiving industrial insurance compensation—Duty to withhold and deliver—Amount.

43.20B.740 - Recipient receiving industrial insurance compensation—Adjudicative proceeding—Collection pending final order.

43.20B.745 - Recipient receiving industrial insurance compensation—Application.

43.20B.750 - Recipients holding title to real property or purchasing under land sales contracts—Recording request for notice or termination or request for notice of transfer or encumbrance of property—Notice and hearing—Rules.

43.20B.900 - Savings—1987 c 75.

43.20B.902 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.