WAC 182-527-2742. Estate recovery — Service-related limitations

For the purposes of this section, the term "agency" includes the agency's designee. The agency's payment for the following services is subject to recovery: (1) State-only funded services, except: (a) Adult protective services; (b) Offender reentry community safety program services; (c) Supplemental security payments (SSP) authorized by developmental disabilities community services (DDCS); (d) Volunteer chore services; and (e) Guardianship and conservatorship assistance program services. (2) For dates of service on and after January 1, 2014: (a) Basic plus waiver services; (b) Community first choice (CFC) services; (c) Community option program entry system (COPES) services; (d) Community protection waiver services; (e) Core waiver services; (f) Hospice services; (g) Intermediate care facility for individuals with intellectual disabilities services provided in either a private community setting or in a rural health clinic; (h) Individual and family services; (i) Medicaid personal care services; (j) New Freedom consumer directed services; (k) Nursing facility services; (l) Personal care services funded under Title XIX or XXI; (m) Private duty nursing administered by the home and community living administration (HCLA); (n) Residential habilitation center services; (o) Residential support waiver services; (p) Roads to community living demonstration project services; (q) The portion of the managed care premium used to pay for HCLA-authorized long-term care services under the program of all-inclusive care for the elderly (PACE); and (r) The hospital and prescription drug services provided to a client while the client was receiving services listed in this subsection. (3) For dates of service beginning January 1, 2010, through December 31, 2013: (a) Medicaid services; (b) Premium payments to managed care organizations (MCOs); and (c) The client's proportional share of the state's monthly contribution to the Centers for Medicare and Medicaid Services to defray the costs for outpatient prescription drug coverage provided to a person who is eligible for medicare Part D and medicaid. (4) For dates of service beginning June 1, 2004, through December 31, 2009: (a) Medicaid services; (b) Medicare premiums for people also receiving medicaid; (c) Medicare savings programs (MSPs) services for people also receiving medicaid; and (d) Premium payments to MCOs. (5) For dates of service beginning July 1, 1995, through May 31, 2004: (a) Adult day health services; (b) Home and community-based services; (c) Medicaid personal care services; (d) Nursing facility services; (e) Private duty nursing services; and (f) The hospital and prescription drug services provided to a client while the client was receiving services listed in this subsection. (6) For dates of service beginning July 1, 1994, through June 30, 1995: (a) Home and community-based services; (b) Nursing facility services; and (c) The hospital and prescription drug services provided to a client while the client was receiving services listed in this subsection. (7) For dates of service beginning July 26, 1987, through June 30, 1994: Medicaid services. (8) For dates of service through December 31, 2009. If a client was eligible for the MSP, but not otherwise medicaid eligible, the client's estate is liable only for any sum paid to cover medicare premiums and cost-sharing benefits. (9) For dates of service beginning January 1, 2010. If a client was eligible for medicaid and the MSP, the client's estate is not liable for any sum paid to cover medical assistance cost-sharing benefits. (10) For dates of service beginning July 1, 2017, long-term services and supports authorized under the medicaid transformation project are exempt from estate recovery. Exempted services include those provided under: (a) Medicaid alternative care under WAC 182-513-1600 ; (b) Tailored supports for older adults under WAC 182-513-1610 ; (c) Supportive housing under WAC 388-106-1700 through 388-106-1765 ; or (d) Supported employment under WAC 388-106-1800 through 388-106-1865 .