Revised Code of Washington
Chapter 48.43 - Insurance Reform.
48.43.016 - Utilization management standards and criteria—Health carrier requirements—Definitions.

RCW 48.43.016
Utilization management standards and criteria—Health carrier requirements—Definitions.

(1) A health carrier or its contracted entity that imposes different prior authorization standards and criteria for a covered service among tiers of contracting providers of the same licensed profession in the same health plan shall inform an enrollee which tier an individual provider or group of providers is in by posting the information on its website in a manner accessible to both enrollees and providers.
(2)(a) A health carrier or its contracted entity may not require utilization management or review of any kind including, but not limited to, prior, concurrent, or postservice authorization for an initial evaluation and management visit and up to six treatment visits with a contracting provider in a new episode of care for each of the following: Chiropractic, physical therapy, occupational therapy, acupuncture and Eastern medicine, massage therapy, or speech and hearing therapies. Visits for which utilization management or review is prohibited under this section are subject to quantitative treatment limits of the health plan. Notwithstanding RCW 48.43.515(5) this section may not be interpreted to limit the ability of a health plan to require a referral or prescription for the therapies listed in this section.
(b) For visits for which utilization management or review is prohibited under this section, a health carrier or its contracted entity may not:
(i) Deny or limit coverage on the basis of medical necessity or appropriateness; or
(ii) Retroactively deny care or refuse payment for the visits.
(3) A health carrier shall post on its website and provide upon the request of a covered person or contracting provider any prior authorization standards, criteria, or information the carrier uses for medical necessity decisions.
(4) A health care provider with whom a health carrier consults regarding a decision to deny, limit, or terminate a person's covered health care services must hold a license, certification, or registration, in good standing and must be in the same or related health field as the health care provider being reviewed or of a specialty whose practice entails the same or similar covered health care service.
(5) A health carrier may not require a provider to provide a discount from usual and customary rates for health care services not covered under a health plan, policy, or other agreement, to which the provider is a party.
(6) Nothing in this section prevents a health carrier from denying coverage based on insurance fraud.
(7) For purposes of this section:
(a) "New episode of care" means treatment for a new condition or diagnosis for which the enrollee has not been treated by a provider of the same licensed profession within the previous ninety days and is not currently undergoing any active treatment.
(b) "Contracting provider" does not include providers employed within an integrated delivery system operated by a carrier licensed under chapter 48.44 or 48.46 RCW.

[ 2020 c 193 § 2; 2019 c 308 § 22; 2018 c 193 § 1; 2015 c 251 § 2.]
NOTES:

Intent—2020 c 193: "The legislature intends to facilitate patient access to appropriate therapies for newly diagnosed health conditions while recognizing the necessity for health carriers to employ reasonable utilization management techniques." [ 2020 c 193 § 1.]


Findings—2019 c 308: See note following RCW 18.06.010.


Effective date—2015 c 251: See note following RCW 41.05.074.

Structure Revised Code of Washington

Revised Code of Washington

Title 48 - Insurance

Chapter 48.43 - Insurance Reform.

48.43.001 - Intent.

48.43.005 - Definitions.

48.43.007 - Availability of price and quality information—Transparency tools for members—Requirements.

48.43.008 - Enrollment in employer-sponsored health plan—Person eligible for medical assistance.

48.43.009 - Health care sharing ministries.

48.43.012 - Health plans—Preexisting conditions—Rules.

48.43.01211 - Health plans—Eligibility—Health status-related factors—Rules.

48.43.0122 - Individual health benefit plans—Open enrollment and special enrollment periods—Rules—Enforcement.

48.43.0123 - Health plans—Rescission of coverage—Rules.

48.43.0124 - Health plans—Cost sharing for essential health benefits—Rules.

48.43.0125 - Essential health benefits—Annual or lifetime dollar limits.

48.43.0126 - Summary of benefits and explanation of coverage—Standards and requirements—Notice of modification—Fines—Standards for definitions of health insurance terms—Rules.

48.43.0127 - Group health plans—Waiting period—Rules.

48.43.0128 - Nongrandfathered health plans and plans issued or renewed on or after January 1, 2022—Prohibited discrimination—Rules.

48.43.016 - Utilization management standards and criteria—Health carrier requirements—Definitions.

48.43.0161 - Prior authorization practices—Carrier annual reporting requirements—Commissioner's standardized report.

48.43.021 - Personally identifiable health information—Restrictions on release.

48.43.022 - Enrollee identification card—Social security number restriction.

48.43.023 - Pharmacy identification cards—Rules.

48.43.028 - Eligibility to purchase certain health benefit plans—Small employers and small groups.

48.43.035 - Group health benefit plans—Guaranteed issue and continuity of coverage—Exceptions.

48.43.038 - Individual health plans—Guarantee of continuity of coverage—Exceptions.

48.43.039 - Grace period—Notification or information—Information concerning delinquencies or nonpayment of premiums—Defined.

48.43.041 - Individual health benefit plans—Mandatory benefits.

48.43.043 - Colorectal cancer examinations and laboratory tests—Required benefits or coverage.

48.43.045 - Health plan requirements—Annual reports—Exemptions.

48.43.047 - Health plans—Minimum coverage for preventative services—No cost-sharing requirements.

48.43.049 - Health carrier data—Information from annual statement—Format prescribed by commissioner—Public availability.

48.43.055 - Procedures for review and adjudication of health care provider complaints—Requirements.

48.43.059 - Payments made by a second-party payment process—Definition.

48.43.065 - Right of individuals to receive services—Right of providers, carriers, and facilities to refuse to participate in or pay for services for reason of conscience or religion—Requirements.

48.43.071 - Health care information—Requirement to provide free copy to covered person appealing denial of social security benefits—Exceptions.

48.43.072 - Required reproductive health care coverage—Restrictions on copayments, deductibles, and other form of cost sharing.

48.43.0725 - Reproductive health plan coverage—Immediate postpartum contraception devices.

48.43.073 - Required abortion coverage—Limitations.

48.43.074 - Qualified health plans—Single invoice billing—Certification of compliance required in the segregation plan for premium amounts attributable to coverage of abortion services.

48.43.078 - Digital breast tomosynthesis—Intent to ensure women with access—Commissioner's and health care authority's duty to clarify mandates.

48.43.081 - Anatomic pathology services—Payment for services—Definitions.

48.43.083 - Chiropractor services—Participating provider agreement—Health carrier reimbursement.

48.43.085 - Health carrier may not prohibit its enrollees from contracting for services outside the health care plan.

48.43.087 - Contracting for services at enrollee's expense—Mental health care practitioner—Conditions—Exception.

48.43.091 - Health carrier coverage of outpatient mental health services—Requirements.

48.43.093 - Health carrier coverage of emergency medical services—Requirements—Conditions.

48.43.094 - Pharmacist provided services—Health plan requirements.

48.43.096 - Medication synchronization policy required for health plans covering prescription drugs—Requirements—Definitions.

48.43.097 - Filing of financial statements—Every health carrier.

48.43.105 - Preparation of documents that compare health carriers—Immunity—Due diligence.

48.43.115 - Maternity services—Intent—Definitions—Patient preference—Clinical sovereignty of provider—Notice to policyholders—Application.

48.43.125 - Coverage at a long-term care facility following hospitalization—Definition.

48.43.176 - Eosinophilic gastrointestinal associated disorder—Elemental formula.

48.43.180 - Denturist services.

48.43.185 - General anesthesia services for dental procedures.

48.43.190 - Payment of chiropractic services—Parity.

48.43.195 - Contraceptive drugs—Twelve-month refill coverage.

48.43.200 - Disclosure of certain material transactions—Report—Information is confidential.

48.43.205 - Material acquisitions or dispositions.

48.43.210 - Asset acquisitions—Asset dispositions.

48.43.215 - Report of a material acquisition or disposition of assets—Information required.

48.43.220 - Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.

48.43.225 - Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements—Information required.

48.43.290 - Coverage for prescribed durable medical equipment and mobility enhancing equipment—Sales and use taxes—Definitions.

48.43.600 - Overpayment recovery—Carrier.

48.43.605 - Overpayment recovery—Health care provider.

48.43.650 - Fixed payment insurance products—Commissioner's annual report.

48.43.670 - Plan or contract renewal—Modification of wellness program.

48.43.680 - Lifetime limit on transplants—Definition.

48.43.690 - Assessments under RCW 70.290.040 considered medical expenses.

48.43.700 - Exchange—Plans that a carrier must offer—Review—Rules.

48.43.705 - Plans offered outside of exchange.

48.43.710 - Certification as qualified health plan not an exemption.

48.43.715 - Individual and small group market—Selection of benchmark plan—Minimum requirements—Criteria—List of state-mandated health benefits.

48.43.720 - Reinsurance and risk adjustment programs—Affordable care act—Rules.

48.43.725 - Exclusion of mandated benefits from health plan—Carrier requirements—Notice—Fees—Commissioner's duties.

48.43.730 - Carrier must file provider contracts and compensation agreements with commissioner—Approval or disapproval—Confidentiality—Hearings—Rules—Definitions.

48.43.731 - Health care benefit management contracts—Carrier filing requirements—Notice to enrollees—Confidentiality of filings.

48.43.733 - Rates and forms of group health benefit plans—Timing of filings—Exceptions—Rules.

48.43.734 - Health carrier rate filings—Review of surplus, capital, and profit levels.

48.43.735 - Reimbursement of health care services provided through telemedicine or store and forward technology—Audio-only telemedicine.

48.43.740 - Dental only plan—Emergency dental conditions—Definitions.

48.43.743 - Dental only plan—Annual data statement—Contents—Public use—Definition.

48.43.750 - Health care provider credentialing applications—Use of electronic database by health carriers.

48.43.755 - Health care provider credentialing applications—Use of electronic database by providers.

48.43.757 - Health care provider credentialing applications—Reimbursement requirements.

48.43.760 - Opioid use disorder—Coverage without prior authorization.

48.43.761 - Withdrawal management services—Substance use disorder treatment services—Prior authorization—Utilization review—Medical necessity review.

48.43.762 - Opioid overdose reversal medication bulk purchasing and distribution program.

48.43.765 - Health carrier network adequacy—Mental health and substance abuse treatment.

48.43.770 - Individual market health plan availability—Annual report.

48.43.775 - Qualified health plan participation—Reimbursement rate for other health plans.

48.43.780 - Insulin drugs—Cap on enrollee's required payment amount—Cost-sharing requirements.

48.43.785 - COVID-19 personal protective equipment expenses—Health care provider reimbursement.

48.43.790 - Behavioral services—Next-day appointments.

48.43.795 - Qualified health plans—Acceptance of premium and cost-sharing assistance.

48.43.800 - Primary care expenditures assessment—Review.

48.43.805 - Prescription drug upper payment limit—Rules.

48.43.810 - Biomarker testing—Standards—Construction.

48.43.815 - Donor human milk—Standards.

48.43.820 - Consolidated appropriations act enforcement—Implementation of federal regulations.

48.43.300 - Definitions.

48.43.305 - Report of RBC levels—Distribution of report—Formula for determination—Commissioner may make adjustments.

48.43.310 - Company action level event—Required RBC plan—Commissioner's review—Notification—Challenge by carrier.

48.43.315 - Regulatory action level event—Required RBC plan—Commissioner's review—Notification—Challenge by carrier.

48.43.320 - Authorized control level event—Commissioner's options.

48.43.325 - Mandatory control level event—Commissioner's duty—Regulatory control.

48.43.330 - Carrier's right to hearing—Request by carrier—Date set by commissioner.

48.43.335 - Confidentiality of RBC reports and plans—Use of certain comparisons prohibited—Certain information intended solely for use by commissioner.

48.43.340 - Powers or duties of commissioner not limited—Rules.

48.43.345 - Foreign or alien carriers—Required RBC report—Commissioner may require RBC plan—Mandatory control level event.

48.43.350 - No liability or cause of action against commissioner or department.

48.43.355 - Notice by commissioner to carrier—When effective.

48.43.360 - Initial RBC reports—Calculation of initial RBC levels—Subsequent reports.

48.43.366 - Self-funded multiple employer welfare arrangements.

48.43.370 - RBC standards not applicable to certain carriers.

48.43.400 - Prescription drug utilization management—Definitions.

48.43.410 - Prescription drug utilization management—Clinical review criteria—Requirement to be evidence-based and updated regularly.

48.43.420 - Prescription drug utilization management—Exception request process—Conditions, requirements, and time frames for approval or denial of requests—Emergency fill coverage—Notice of new policies and procedures.

48.43.430 - Prescription medication—Maximum charge at point of sale—Requirements.

48.43.435 - Prescription medication—Cost-sharing calculation—Application—Rules.

48.43.500 - Intent—Purpose—2000 c 5.

48.43.505 - Enrollee's and protected individual's right to privacy and confidential services—Health carrier or insurer duties—Requests for confidential communications—Rules.

48.43.5051 - Requests for confidential communications—Monitoring and ensuring compliance—Standardized form for submission of requests—Rules.

48.43.510 - Carrier required to disclose health plan information—Marketing and advertising restrictions—Rules.

48.43.515 - Access to appropriate health services—Enrollee options—Rules.

48.43.517 - Enrollment of child participating in medical assistance program—Employer-sponsored health plan.

48.43.520 - Requirement to maintain a documented utilization review program description and written utilization review criteria—Rules.

48.43.525 - Prohibition against retrospective denial of health plan coverage—Rules.

48.43.530 - Requirement for carriers to have comprehensive grievance and appeal processes—Carrier's duties—Procedures—Appeals—Rules.

48.43.535 - Independent review of health care disputes—System for using certified independent review organizations—Rules.

48.43.537 - Health care disputes—Certifying independent review organizations—Application—Restrictions—Maximum fee schedule for conducting reviews—Rules.

48.43.540 - Requirement to designate a licensed medical director—Exemption.

48.43.545 - Standard of care—Liability—Causes of action—Defense—Exception.

48.43.550 - Delegation of duties—Carrier accountability.

48.43.902 - Effective date—1996 c 312.

48.43.904 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.