1. (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. (2) The medicaid agency may pay for hospice care provided to a client:

   1. (a) Covered by medicaid part B (medical insurance); and
   2. (b) Not covered by medicare part A.

3. (3) For hospice care provided to a medicaid-medicare dual eligible client, hospice agencies are responsible to bill:

   1. (a) Medicare before billing the medicaid agency;
   2. (b) The medicaid agency for hospice nursing facility room and board;
   3. (c) The medicaid agency for hospice care center room and board; and
   4. (d) Medicare for general inpatient care or inpatient respite care.
4. (4) All the limitations and requirements related to hospice care described in subchapter I apply to the payments described in this section.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 25-16-015, s 182-551-1530, filed 7/25/25, effective 9/1/25; WSR 16-03-035, § 182-551-1530, filed 1/12/16, effective 2/12/16. Statutory Authority: RCW 41.05.021, Section 2302 of the Patient Protection and Affordable Care Act of 2010 (P.L. 111-148), and Section 1814 (a)(7) of the Social Security Act. WSR 12-09-079, § 182-551-1530, filed 4/17/12, effective 5/18/12. WSR 11-14-075, recodified as § 182-551-1530, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-18-033, § 388-551-1530, filed 8/30/05, effective 10/1/05. Statutory Authority: RCW 74.09.520 and 74.08.090, 42 C.F.R. 418.22 and 418.24. WSR 99-09-007, § 388-551-1530, filed 4/9/99, effective 5/10/99.]