Revised Code of Washington
Chapter 48.43 - Insurance Reform.
48.43.115 - Maternity services—Intent—Definitions—Patient preference—Clinical sovereignty of provider—Notice to policyholders—Application.

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

(1) The legislature recognizes the role of health care providers as the appropriate authority to determine and establish the delivery of quality health care services to maternity patients and their newly born children. It is the intent of the legislature to recognize patient preference and the clinical sovereignty of providers as they make determinations regarding services provided and the length of time individual patients may need to remain in a health care facility after giving birth. It is not the intent of the legislature to diminish a carrier's ability to utilize managed care strategies but to ensure the clinical judgment of the provider is not undermined by restrictive carrier contracts or utilization review criteria that fail to recognize individual postpartum needs.
(2) Unless otherwise specifically provided, the following definitions apply throughout this section:
(a) "Attending provider" means a provider who: Has clinical hospital privileges consistent with RCW 70.43.020; is included in a provider network of the carrier that is providing coverage; and is a physician licensed under chapter 18.57 or 18.71 RCW, a certified nurse midwife licensed under chapter 18.79 RCW, a midwife licensed under chapter 18.50 RCW, a physician's assistant licensed under chapter 18.71A RCW, or an advanced registered nurse practitioner licensed under chapter 18.79 RCW.
(b) "Health carrier" or "carrier" means disability insurers regulated under chapter 48.20 or 48.21 RCW, health care services contractors regulated under chapter 48.44 RCW, health maintenance organizations regulated under chapter 48.46 RCW, plans operating under the health care authority under chapter 41.05 RCW, the state health insurance pool operating under chapter 48.41 RCW, and insuring entities regulated under this chapter.
(3)(a) Every health carrier that provides coverage for maternity services must permit the attending provider, in consultation with the mother, to make decisions on the length of inpatient stay, rather than making such decisions through contracts or agreements between providers, hospitals, and insurers. These decisions must be based on accepted medical practice.
(b) Covered eligible services may not be denied for inpatient, postdelivery care to a mother and her newly born child after a vaginal delivery or a cesarean section delivery for such care as ordered by the attending provider in consultation with the mother.
(c) At the time of discharge, determination of the type and location of follow-up care must be made by the attending provider in consultation with the mother rather than by contract or agreement between the hospital and the insurer. These decisions must be based on accepted medical practice.
(d) Covered eligible services may not be denied for follow-up care, including in-person care, as ordered by the attending provider in consultation with the mother. Coverage for providers of follow-up services must include, but need not be limited to, attending providers as defined in this section, home health agencies licensed under chapter 70.127 RCW, and registered nurses licensed under chapter 18.79 RCW.
(e) This section does not require attending providers to authorize care they believe to be medically unnecessary.
(f) Coverage for the newly born child must be no less than the coverage of the child's mother for no less than three weeks, even if there are separate hospital admissions.
(4) A carrier that provides coverage for maternity services may not deselect, terminate the services of, require additional documentation from, require additional utilization review of, reduce payments to, or otherwise provide financial disincentives to any attending provider or health care facility solely as a result of the attending provider or health care facility ordering care consistent with this section. This section does not prevent any insurer from reimbursing an attending provider or health care facility on a capitated, case rate, or other financial incentive basis.
(5) Every carrier that provides coverage for maternity services must provide notice to policyholders regarding the coverage required under this section. The notice must be in writing and must be transmitted at the earliest of the next mailing to the policyholder, the yearly summary of benefits sent to the policyholder, or January 1 of the year following June 6, 1996.
(6) This section does not establish a standard of medical care.
(7) This section applies to coverage for maternity services under a contract issued or renewed by a health carrier after June 6, 1996, and applies to plans operating under the health care authority under chapter 41.05 RCW beginning January 1, 1998.

[ 2020 c 80 § 37; 2003 c 248 § 14; 1996 c 281 § 1.]
NOTES:

Effective date—2020 c 80 §§ 12-59: See note following RCW 7.68.030.


Intent—2020 c 80: See note following RCW 18.71A.010.


Short title—1996 c 281: "This act shall be known as "the Erin Act."" [ 1996 c 281 § 3.]

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.