- (1) Medicaid program reimbursement rates established according to this chapter apply only to facilities holding appropriate state licenses and certified to provide ICF/ID services according to state and federal laws and regulations.
- (2) All rates must be reasonable and adequate to meet the costs incurred by economically and efficiently operated facilities providing ICF/ID services according to state and federal laws and regulations.
(3) For private facilities:
- (a) Final payments must be the lower of the facility's prospective rate or allowable costs.
- (b) Prospective rates must be determined according to WAC 388-835-0845, 388-835-0850, 388-835-0860, 388-835-0865, 388-835-0870, 388-835-0875, and 388-835-0880.
- (c) Final payments must be determined according to WAC 388-835-0880.
(4) For state facilities:
- (a) Final payments must be the facility's allowable costs.
- (b) Interim rates must be calculated using the most recent annual reported costs (see WAC 388-835-0845) divided by the total resident days during the reporting period. These costs may be adjusted to incorporate federal, state, or department changes in program standards or services.
- (c) Final payments must be determined according to WAC 388-835-0880.
[Statutory Authority: RCW 71A.12.030 and 44.04.280. WSR 15-09-069, § 388-835-0575, filed 4/15/15, effective 5/16/15. Statutory Authority: RCW 71A.16.010, 71A.16.030, 71A.12.030, chapter 71A.20 RCW, RCW 72.01.090, and 72.33.125. WSR 02-16-014, § 388-835-0575, filed 7/25/02, effective 8/25/02. Statutory Authority: RCW 71A.20.140. WSR 01-10-013, § 388-835-0575, filed 4/20/01, effective 5/21/01.]