WAC 388-505-0540 Assignment of rights and cooperation

1. When a person becomes eligible for any medical assistance program, they make assignment of some of their rights to the state of Washington. This assignment includes all rights to any type of coverage for medical care which results from:

   1. A court order; 

   2. An administrative agency order; or

   3. Any third-party benefits or payment obligations for medical care which are the result of subrogation or contract (see WAC 388-87-020). (Ed Note:  The correct reference is WAC 388-501-0100.

2. Subrogation is a legal term which describes the method by which the state acquires the rights of a client for whom or to whom the state has paid benefits. The subrogation rights of the state are limited to the recovery of its own costs.

3. The person who signs the application makes the assignment of rights to the state. Assignment is made on their own behalf and on behalf of any eligible person for whom they can legally make such assignment.

4. A person must cooperate with the department in the identification, use or collection of third-party benefits. Failure to cooperate will result in a termination of eligibility for the responsible person. Other obligations for cooperation are located in chapters 388-14 (Ed. Note:  This correct reference is chapter 388-14A WAC.) and 388-422 WAC. The following clients are exempt from termination of eligibility for noncooperation:

   1. A pregnant woman, and

   2. Minor children, and

   3. A person who has been determined to have "good cause" for noncooperation (see WAC 388-422-0015).  (Ed. Note:  The reference is incorrect.  The correct reference is WAC 388-422-0020.).

5. A person will not lose eligibility for medical assistance programs due solely to the noncooperation of any third party.

6. A person will be responsible for the costs of otherwise covered medical services if:

   1. the person received and kept the third party payment for those services, or;

   2. the person refused to provide to the provider of care their legal signature on insurance forms.