Office of Financial Recovery
More About Our Recovery Services:
How to Find Us, Who to Call
THIS INFORMATION HAS BEEN PREPARED for those who want to know more about our services, or would like to reach us directly. Our office is located in Lacey, Washington. To schedule an appointment, or reach us by phone, please call 360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388.
You may also call the number above to obtain directions and a parking pass. Parking is free, but a parking pass is required.
| Phone: | (360) 664-5800 |
| 1-800-562-6114 | |
| 1-800-833-6388 (TTY WA) | |
| Mailing Address: | PO Box 45862 |
| Olympia, WA 98504-5862 |
Federal Law established the Medicaid prescription drug program commonly called the Drug-Rebate Program. Responsibility for the program is shared among the drug manufacturers, Centers for Medicaid and Medicare Services (CMS), and DSHS. Drug manufacturers must enter into a rebate agreement with the state. DSHS is responsible for reporting, to the manufacturer, the total number of dosage units of each covered outpatient drug dispensed each quarter.
The manufacturer is required to provide CMS the average manufacturer's price and the best price for each covered drug, and then CMS calculates the rebate. DSHS' Health and Recovery Services Administration (HRSA) bills the manufacturer for the rebate due. OFR manages the fiscal accountability and recovery of the accounts receivable.
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
Developmental Disabilities Program
OFR determines a non-Medicaid resident's liability to pay cost of care. A Notice and Finding of Responsibility (NFR) is established, and once final, becomes the basis for recovery from first party sources. State Operated Living Alternatives (SOLA) facilities offer options to persons with developmental disabilities in their living arrangements to ensure safe care and maximum independence. OFR verifies eligibility for Medicaid payments and generates bills for the patients for the cost of services provided.
OFR verifies Medicaid eligibility and works with the facilities, families, and responsible party's to ensure that patients receive the appropriate benefits for which they are eligible. Once the determination is completed by the Community Service Office (CSO), bills are sent to Medicaid. The CSOs conduct annual reviews to help ensure the appropriate level of benefits are maintained. OFR monitors all cases to ensure payments are received.
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
OFR recovers correctly paid long-term care services, Medicaid assistance, and related medical charges from the estates of decedents. Recovery may be made from estates of recipients of state-funded long-term care services (without regard to age) and Medicaid services aged 55 and older at the time of death.
Upon receiving notice of a recipient's death, OFR investigates to determine if the decedent's estate has resources and whether a claim to recover costs of service provided to the decedent can be made within the parameters of the estate recovery statute. If these conditions are met, a lien is filed against the decedent's property and/or a Notice to the Creditor claim is filed against the decedent's estate in probate court. HRSA and ADSA rely on these funds to help offset the cost of medical and personal (i.e., COPES) care delivered to current recipients
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
OFR recovers debts due DSHS from vendors who provide services to the department or DSHS clients. These debts include vendor overpayments, nursing home cost settlements, civil fines, and certification fees. Vendor overpayments can occur in any DSHS program. Overpayments are discovered through program or performance audits, computer records (Payment Reliability Program), program staff reviews, and vendors.
Recovery actions may include recoupment from future payments, negotiating repayment agreements, legal actions, demands against security posted by vendors, or filing liens. The vendor unit also recovers miscellaneous debts due the department such as employee overpayments and overpayments established by the Child Welfare Training and Advancement Program (CWTAP)
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
State law requires parents of juvenile offenders pay a percentage of their gross income to the department for the cost of the juvenile's support, treatment, and confinement in DSHS Juvenile Rehabilitation Institutions. Ability to pay is based on a percentage of each parent's income in accordance with a sliding fee schedule.
A Notice of Finding of Financial Responsibility (NFFR) establishes the debt and forms the legal basis for collection and enforcement. OFR collects amounts owed for the Juvenile Rehabilitation Administration (JRA), and is responsible for establishing, managing, and collecting the accounts receivable.
JRA uses these funds to help offset unanticipated budget costs, such as unexpected medical cost incurred by seriously ill juveniles in custody
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
OFR manages the Supplemental Security Income (SSI) interim assistance reimbursement program. The state of Washington has an agreement with the federal department of Health and Human Services, Social Security Administration (SSA) to provide interim assistance to incapacitated adults without dependents under the General Assistance-Unemployable program while their SSI application is pending.
OFR then receives the retroactive SSI award, retains the interim assistance amount paid by DSHS, and forwards the remainder to the client. Under certain conditions, state law allows for payment of attorney fees from the amount retained by DSHSMental Health
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
OFR manages the recovery for patient care provided at state psychiatric hospitals: Admission to a state hospital is based on a need for services, not on the ability to pay for those services. A patient's liability for cost of care and ability to pay is determined by OFR staff based on the patient's or other responsible party's financial resources. When available, third party resources such as Medicare, Medicaid, and private insurance are billed first.
Financial resources include cash, negotiable assets, real property, wages, federal entitlements, and private medical insurance. After financial resources have been investigated and identified, a Notice and Finding of Responsibility (NFR) is served which establishes the legal basis for collection and enforcement of first party liability.
Program for Adaptive Living Skills (PALS) is an adult residential treatment facility designed to assist psychiatrically impaired adults to live independently at a level consistent with their abilities and is less costly and restrictive than a hospital setting. The Mental Health Division of DSHS manages collections for the program and is responsible for setting the per diem rates for care at PALS. OFR establishes a contractual liability with the resident based on income and resources.
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
OFR manages billing and accounting for three medical assistance programs administered by DSHS; the Children's Health Insurance Program (CHIP), Healthcare for Workers with Disabilities (HWD) and Medical Extension Benefits (MEB) programs.
Together these programs provide medical coverage for over 8,500 children and adults that would otherwise not have health insurance. OFR's success and the value of these programs have resulted in the development of a similar program that will bring subsidized DSHS medical insurance to over 60,000 Washington state residents.
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
Recoupments are made from the Labor and Industries (L&I) Time Loss benefits that duplicate financial assistance paid to clients by DSHS is managed by OFR. Identification of duplicated benefits is accomplished in several ways:
. CSO caseworker notification to OFR of potential time loss benefits
. Computer interface with L&I
. Claims manager and other inquiries
Duplicated benefit amounts are computed by OFR and files liens against the time loss benefit. L&I deducts the OFR claim amount from the client's Time Loss benefits.
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
OFR is responsible for the recovery of financial, medical, social services, and food assistance overpayments.
The Community Service Office (CSO) discovers the overpayment, notifies the client, and refers the overpayment to OFR. For clients receiving financial assistance, a deduction may be taken from their monthly grant or when receiving food assistance from their allotment. For clients no longer receiving assistance, other administrative and judicial recovery actions may be taken.
The food assistance program is federally funded, therefore, federal payments including income tax refunds, wages, and social security benefits can be offset to repay delinquent food assistance debts through the Treasury Offset Program (TOP).
Most food assistance recoveries are forwarded to the federal government but a percentage of each dollar collected is retained and sent to Washington's general fund.
For more information call:
360-664-5700, 1-800-562-6114, or TTY WA 1-800-833-6388
The foreclosure process is an enforcements tool available to all collections units within the Office of Financial Recovery that have statuatory authority to record a lien against real property. A lien must be filed and recorded before the foreclosure process can begin.
For property info contact: (360) 664.5476 or send your name, e-mail address or fax number to batdoce@dshs.wa.gov
This site was last modified: December 6th, 2006
Contact Thomas Martin for more information about the Office of Financial Recovery. (360) 664-5507 or martith@dshs.wa.gov
For more ways to get in touch with the Department of Social and Health Services go to the DSHS Contact Information Web page.
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