WAC 182-532-790 TAKE CHARGE program - Good cause exemption from billing third party insurance.

Effective September 1, 2013

  1. Under the TAKE CHARGE program, two groups of clients may request an exemption from the medicaid requirement to bill third-party insurance due to "good cause." The two groups are:
    1. TAKE CHARGE applicants who:
      1. Are eighteen years of age or younger;
      2. Are covered under their parents' health insurance; and
      3. Do not want their parents to know that they are seeking and/or receiving family planning services.
    2. Individuals who are domestic violence victims and are covered under the perpetrator's health insurance.
  2. "Good cause" means that the use of the third-party coverage would violate a client's confidentiality because the third party:
    1. Routinely sends verification of services to the third-party subscriber and that subscriber is someone other than the applicant; and/or
    2. Requires the applicant to use a primary care provider who is likely to report the applicant's request for family planning services to the subscriber.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.