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Washington Administrative Code (Last Updated: November 23, 2016) |
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Title 388. Social and Health Services, Department of |
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Chapter 388-877. Behavioral health services administrative requirements. |
Section 388-877-0665. Notice of action.
Latest version.
- (1) The behavioral health organization's (BHO's) notice of action provided to an individual must be in writing, be in the individual's primary language, be easily understood and, at a minimum, explain:(a) The action the BHO or its contractor (behavioral health agency) has taken or intends to take;(b) The reason for the action and a citation of the rule(s) being implemented;(c) The individual's right to file an appeal with the BHO and the required timeframes if the individual does not agree with the decision or action;(d) The circumstances under which an expedited resolution is available and how to request it; and(e) The individual's right to receive behavioral health services while an appeal is pending, how to make the request, and that the individual may be held liable for the cost of services received while the appeal is pending if the appeal decision upholds the decision or action.(2) When the BHO or its contracted behavioral health agency does not reach service authorization decisions within the required timeframes, or fails to provide services in a timely manner or to act within the grievance system timeframes, as defined in rule, it is considered a denial. In these cases, the BHO sends a formal notice of action, which includes the individual's right to request an administrative hearing.