Civil rights and complaints

WAC 182-503-0100 Washington apple health -- Rights and responsibilities.

Effective March 31, 2014.

For the purposes of this chapter, "we" refers to the agency or its designee and "you" refers to the applicant for, or recipient of, health care coverage.

1. If you are applying for or receiving health care coverage, you have the right to:
   1. Have your rights and responsibilities explained to you and given in writing;
   2. Be treated politely and fairly without regard to your race, color, political beliefs, national origin, religion, age, gender (including gender identity and sex stereotyping), sexual orientation, disability, honorably discharged veteran or military status, or birthplace;
   3. Ask for health care coverage using any method listed under WAC 182-503-0010 (if you ask us for a receipt or confirmation, we will provide one to you);
   4. Get help completing your application if you ask for it;
   5. Have an application processed promptly and no later than the timelines described in WAC 182-503-0060;
   6. Have at least ten calendar days to give the agency or its designee information needed to determine eligibility and be given more time if asked for;
   7. Have personal information kept confidential; we may share information with other state and federal agencies for purposes of eligibility and enrollment in Washington apple health;
   8. Get written notice, in most cases, at least ten calendar days before the agency or its designee denies, terminates, or changes coverage;
   9. Ask for an appeal if you disagree with a decision we make. You can also ask a supervisor or administrator to review our decision or action without affecting your right to a fair hearing;
   10. Ask for and get interpreter or translator services at no cost and without delay;
   11. Ask for voter registration assistance;
   12. Refuse to speak to an investigator if we audit your case. You do not have to let an investigator into your home. You may ask the investigator to come back at another time. Such a request will not affect your eligibility for health care coverage;
   13. Get equal access services under WAC 182-503-0120 if you are eligible;
   14. Ask for support enforcement services through the division of child support; and
   15. Refuse to cooperate with us in identifying, using, or collecting third-party benefits (such as medical support) if you fear, and can verify, that your cooperating with us could result in serious physical or emotional harm to you, your children, or a child in your care. Verification may include one of the following:
       1. A statement you sign, outlining your fears and concerns;
       2. Civil or criminal court orders (such as domestic violence protection orders, restraining orders, and no-contact orders);
       3. Medical, police, or court reports; or
       4. Written statement from clergy, friends, relatives, neighbors, or co-workers.
2. You are responsible to:
   1. Report changes in your household or family circumstances as required under WAC 182-504-0105 and 182-504-0110;
   2. Give us any information or proof needed to determine eligibility. If you have trouble getting proof, we help you get the proof or contact other persons or agencies for it;
   3. Assign the right to medical support as described in WAC 182-505-0540, unless you can submit verification (which may include one of the items listed in subsection (1)(o) of this section) that your cooperating with us could result in serious physical or emotional harm to you, your children, or a child in your care;
   4. Complete renewals when asked;
   5. Apply for and make a reasonable effort to get potential income from other sources when available;
   6. Give medical providers information needed to bill us for health care services; and
   7. Cooperate with quality assurance or post enrollment review staff when asked.