Revised Code of Washington
Chapter 48.49 - Balance Billing Protection Act.
48.49.070 - Hospital, ambulatory surgical facility, or behavioral health emergency services provider—Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists.

RCW 48.49.070
Hospital, ambulatory surgical facility, or behavioral health emergency services provider—Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists.

(1)(a) A hospital, ambulatory surgical facility, or behavioral health emergency services provider must post the following information on its website, if one is available:
(i) The listing of the carrier health plan provider networks with which the hospital, ambulatory surgical facility, or behavioral health emergency services provider is an in-network provider, based upon the information provided by the carrier pursuant to RCW 48.43.730(7); and
(ii) The notice of consumer rights developed under RCW 48.49.060.
(b) If the hospital, ambulatory surgical facility, or behavioral health emergency services provider does not maintain a website, this information must be provided to consumers upon an oral or written request.
(2) Posting or otherwise providing the information required in this section does not relieve a hospital, ambulatory surgical facility, or behavioral health emergency services provider of its obligation to comply with the provisions of this chapter.
(3) Not less than thirty days prior to executing a contract with a carrier, a hospital or ambulatory surgical facility must provide the carrier with a list of the nonemployed providers or provider groups contracted to provide emergency medicine, anesthesiology, pathology, radiology, neonatology, surgery, hospitalist, intensivist[,] and diagnostic services, including radiology and laboratory services at the hospital or ambulatory surgical facility. The hospital or ambulatory surgical facility must notify the carrier within thirty days of a removal from or addition to the nonemployed provider list. A hospital or ambulatory surgical facility also must provide an updated list of these providers within fourteen calendar days of a request for an updated list by a carrier.

[ 2022 c 263 § 14; 2019 c 427 § 11.]
NOTES:

Effective date—2022 c 263: See note following RCW 43.371.100.

Structure Revised Code of Washington

Revised Code of Washington

Title 48 - Insurance

Chapter 48.49 - Balance Billing Protection Act.

48.49.003 - Findings—Intent—2019 c 427.

48.49.005 - Short title.

48.49.010 - Definitions.

48.49.020 - Balance billing—When prohibited—Carrier's duty to hold an enrollee harmless from balance billing under certain circumstances.

48.49.030 - Enrollee's obligation to pay for services.

48.49.040 - Dispute resolution process—Determination of commercially reasonable payment amount.

48.49.050 - Commissioner's annual report on dispute resolution information regarding arbitration over commercially reasonable payment amounts.

48.49.060 - Notice of consumer rights—Development of standard template language by commissioner.

48.49.070 - Hospital, ambulatory surgical facility, or behavioral health emergency services provider—Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists.

48.49.080 - Health care provider—Requirement to provide certain information on website or upon consumer request—Requirement to submit network status information to carriers.

48.49.090 - Carrier—Requirement to update website and provider directory—Requirement to provide enrollee with certain information.

48.49.100 - Pattern of unresolved violations—Enforcement action by department of health or appropriate disciplining authority.

48.49.110 - Rule-making authority.

48.49.120 - No application of chapter to health plans under chapter 74.09 RCW.

48.49.130 - Application of chapter to self-funded group health plans that elect to participate in balance billing protection provisions—Annual notice to commissioner.

48.49.135 - Determining the adequacy of provider networks—Required considerations.

48.49.140 - Liberal construction of chapter to promote public interest.

48.49.160 - Allowed amounts paid to nonparticipating providers.

48.49.170 - Application of state and federal requirements—Applicability information access—Waivers prohibited.

48.49.180 - Commissioner authority—Enforcement—Penalties.

48.49.190 - Reports to legislature.

48.49.900 - Effective date—2019 c 427.