WAC 182-551-1530. Payment method for medicaid-medicare dual eligible clients

(1) The medicaid agency does not pay the portion of hospice care for a client who is covered under medicare part A. Nursing home room and board charges described in WAC 182-551-1510 that are not covered under medicare part A may be covered by the medicaid agency. (2) The medicaid agency may pay for hospice care provided to a client: (a) Covered by medicaid part B (medical insurance); and (b) Not covered by medicare part A. (3) For hospice care provided to a medicaid-medicare dual eligible client, hospice agencies are responsible to bill: (a) Medicare before billing the medicaid agency; (b) The medicaid agency for hospice nursing facility room and board; (c) The medicaid agency for hospice care center room and board; and (d) Medicare for general inpatient care or inpatient respite care. (4) All the limitations and requirements related to hospice care described in subchapter I apply to the payments described in this section.