RCW 41.05.670
Chronic care management incentives—Provider reimbursement methods.
(1) Effective January 1, 2013, the authority must contract with all of the public employees' benefits board managed care plans and the self-insured plan or plans to include provider reimbursement methods that incentivize chronic care management within health homes resulting in reduced emergency department and inpatient use.
(2) Health home services contracted for under this section may be prioritized to enrollees with complex, high cost, or multiple chronic conditions.
(3) For the purposes of this section, "chronic care management" and "health home" have the same meaning as in RCW 74.09.010.
(4) Contracts with fully insured plans and with any third-party administrator for the self-funded plan that include the items in subsection (1) of this section must be funded within the resources provided by employer funding rates provided for employee health benefits in the omnibus appropriations act.
(5) Nothing in this section shall require contracted third-party health plans administering the self-insured contract to expend resources to implement items in subsection (1) of this section beyond the resources provided by employer funding rates provided for employee health benefits in the omnibus appropriations act or from other sources in the absence of these provisions.
(6) The school employees' benefits board, under RCW 41.05.740, shall implement the provisions of this section, effective January 1, 2020.
[ 2017 3rd sp.s. c 13 § 812; 2011 c 316 § 6.]
NOTES:
Intent—2017 3rd sp.s. c 13: See note following RCW 28A.150.410.
Structure Revised Code of Washington
Title 41 - Public Employment, Civil Service, and Pensions
Chapter 41.05 - State Health Care Authority.
41.05.004 - Intent—Use of word "board."
41.05.008 - Duties of employing agencies.
41.05.009 - Determination of employee or school employee eligibility for benefits.
41.05.0091 - Eligibility exists prior to January 1, 2010.
41.05.013 - State purchased health care programs—Uniform policies—Report to the legislature.
41.05.014 - Applications, enrollment forms, and eligibility certification documents—Signatures.
41.05.015 - Medical director—Appointment of personnel.
41.05.017 - Provisions applicable to health plans offered under this chapter.
41.05.022 - State agent for purchasing health services—Single community-rated risk pool.
41.05.023 - Chronic care management program—Uniform medical plan—Definitions.
41.05.031 - Agencies to establish health care information systems.
41.05.033 - Shared decision-making demonstration project—Preference-sensitive care.
41.05.036 - Health information—Definitions.
41.05.037 - Nurse hotline, when funded.
41.05.039 - Health information—Secure access—Lead organization—Administrator's duties.
41.05.042 - Health information—Processes, guidelines, and standards.
41.05.046 - Health information—Conflict with federal requirements.
41.05.050 - Contributions for employees and dependents—Definitions.
41.05.055 - Public employees' benefits board—Members.
41.05.065 - Public employees' benefits board—Duties—Eligibility—Definitions—Penalties.
41.05.066 - Domestic partner benefits.
41.05.068 - Federal employer incentive program—Authority to participate.
41.05.085 - Retired state employee and retired or disabled school employee health insurance subsidy.
41.05.095 - Coverage for dependents under the age of twenty-six.
41.05.100 - Chapter not applicable to certain employees of Cooperative Extension Service.
41.05.110 - Chapter not applicable to officers and employees of state convention and trade center.
41.05.120 - Public employees' and retirees' insurance account—School employees' insurance account.
41.05.140 - Payment of claims—Self-insurance—Insurance reserve fund created.
41.05.165 - Rules—Insurance benefit reimbursement.
41.05.170 - Neurodevelopmental therapies—Employer-sponsored group contracts.
41.05.175 - Prescribed, self-administered anticancer medication.
41.05.177 - Prostate cancer screening—Required coverage.
41.05.180 - Mammograms—Insurance coverage.
41.05.183 - General anesthesia services for dental procedures—Public employee benefit plans.
41.05.185 - Diabetes benefits—State purchased health care.
41.05.188 - Eosinophilic gastrointestinal associated disorder—Elemental formula.
41.05.195 - Medicare supplemental insurance policies.
41.05.197 - Medicare supplemental insurance policies.
41.05.205 - Tricare supplemental insurance policy—Authority to offer—Rules.
41.05.225 - Blind licensees in the business enterprises program—Plan of health insurance.
41.05.240 - American Indian health care delivery plan.
41.05.280 - Department of corrections—Inmate health care.
41.05.295 - Dependent care assistance program—Health care authority—Powers, duties, and functions.
41.05.300 - Salary reduction agreements—Authorized.
41.05.310 - Salary reduction plan—Policies and procedures—Plan document.
41.05.320 - Salary reduction plan—Eligibility—Participation, withdrawal.
41.05.330 - Salary reduction plan—Accounts and records.
41.05.340 - Salary reduction plan—Termination—Amendment.
41.05.350 - Salary reduction plan—Rules.
41.05.360 - Salary reduction plan—Construction.
41.05.405 - Public option plans—Availability—Hospital contracts—Recommendations.
41.05.410 - Qualified health plans—Contract for—Requirements—Cost and quality data.
41.05.413 - Qualified health plans—Reimbursement limit—Waiver.
41.05.420 - Plan of health care coverage—Prescription insulin drug cost limits—Cost sharing.
41.05.430 - Plan of health care coverage—Immediate postpartum contraception devices.
41.05.520 - Pharmacy connection program—Notice.
41.05.525 - Treatment of opioid use disorder—Prior authorization.
41.05.527 - Opioid overdose reversal medication bulk purchasing and distribution program.
41.05.530 - Prescription drug assistance, education—Rules.
41.05.540 - State employee health program—Requirements—Report.
41.05.600 - Mental health services—Definition—Coverage required, when.
41.05.601 - Mental health services—Rules.
41.05.630 - Annual report of customer service complaints and appeals.
41.05.660 - Community health care collaborative grant program—Award and disbursement of grants.
41.05.670 - Chronic care management incentives—Provider reimbursement methods.
41.05.680 - Report—Chronic care management.
41.05.740 - School employees' benefits board.
41.05.742 - Single enrollment requirement.
41.05.744 - School employee eligibility during COVID-19 state of emergency.
41.05.745 - School employees' benefits board—Employee-paid, voluntary benefits—Optional benefits.
41.05.750 - Problem and pathological gambling treatment program.
41.05.751 - Problem gambling account.
41.05.760 - Recovery residences—Registry.
41.05.761 - Recovery residences—Technical assistance for residences seeking certification.
41.05.762 - Recovery residences—Revolving fund.
41.05.765 - Insulin drugs—Cap on enrollee's required payment amount—Cost-sharing requirements.
41.05.830 - Coverage for hearing instruments—Definitions.