Health insurers,
as a condition of doing business in Washington, must:
(1) Provide, with respect to individuals who are eligible
for, or are provided, medical assistance under chapter 74.09 RCW,
upon the request of the department, information to determine
during what period the individual or their spouses or their
dependants may be, or may have been, covered by a health insurer
and the nature of coverage that is or was provided by the health
insurer, including the name, address, and identifying number of
the plan, in a manner prescribed by the department;
(2) Accept the department's right to recovery and the
assignment to the department of any right of an individual or
other entity to payment from the party for an item or service for
which payment has been made under chapter 74.09 RCW;
(3) Respond to any inquiry by the department regarding a
claim for payment for any health care item or service that is
submitted not later than three years after the date of the
provision of such health care item or service;
(4) Agree not to deny a claim submitted by the department
solely on the basis of the date of submission of the claim, the
type or format of the claim form, or a failure to present proper
documentation at the point-of-sale that is the basis of the
claim, if:
(a) The claim is submitted by the department within the
three-year period beginning on the date the item or service was
furnished; and
(b) Any action by the department to enforce its rights with
respect to such claim is commenced within six years of the
department's submission of such claim; and
(5) Agree that the prevailing party in any legal action to
enforce this section receives reasonable attorneys' fees as well
as related collection fees and costs incurred in the enforcement
of this section.
[2007 c 179 § 4.]
NOTES:
Effective date -- 2007 c 179: See note following RCW 74.09A.005.