RCW 70.14.110
Health technology clinical committee determinations.
(1) The committee shall determine, for each health technology selected for review under RCW 70.14.100: (a) The conditions, if any, under which the health technology will be included as a covered benefit in health care programs of participating agencies; and (b) if covered, the criteria which the participating agency administering the program must use to decide whether the technology is medically necessary, or proper and necessary treatment.
(2) In making a determination under subsection (1) of this section, the committee:
(a) Shall consider, in an open and transparent process, evidence regarding the safety, efficacy, and cost-effectiveness of the technology as set forth in the systematic assessment conducted under RCW 70.14.100(4);
(b) Shall provide an opportunity for public comment; and
(c) May establish ad hoc temporary advisory groups if specialized expertise is needed to review a particular health technology or group of health technologies, or to seek input from enrollees or clients of state purchased health care programs. Advisory group members are immune from civil liability for any official act performed in good faith as a member of the group. As a condition of appointment, each person shall agree to the terms and conditions imposed by the administrator regarding conflicts of interest.
(3) Determinations of the committee under subsection (1) of this section shall be consistent with decisions made under the federal medicare program and in expert treatment guidelines, including those from specialty physician organizations and patient advocacy organizations, unless the committee concludes, based on its review of the systematic assessment, that substantial evidence regarding the safety, efficacy, and cost-effectiveness of the technology supports a contrary determination.
[ 2006 c 307 § 4.]
NOTES:
Captions not law—Conflict with federal requirements—2006 c 307: See notes following RCW 70.14.080.
Structure Revised Code of Washington
Title 70 - Public Health and Safety
Chapter 70.14 - Health Care Services Purchased by State Agencies.
70.14.020 - State agencies to identify alternative health care providers.
70.14.030 - Health care utilization review procedures.
70.14.040 - Review of prospective rate setting methods.
70.14.050 - Drug purchasing cost controls—Establishment of evidence-based prescription drug program.
70.14.060 - Prescription drug purchasing consortium—Participation—Exceptions—Rules.
70.14.065 - Generic prescription drug partnership agreements.
70.14.070 - Prescription drug consortium account.
70.14.090 - Health technology clinical committee.
70.14.100 - Health technology selection and assessment.
70.14.110 - Health technology clinical committee determinations.
70.14.130 - Health technology clinical committee—Public notice.
70.14.140 - Applicability to health care services purchased from health carriers.
70.14.150 - Data-sharing agreements—Report.
70.14.155 - Streamlined health care administration—Agency participation.
70.14.160 - Total cost of insulin work group—Appointment—Duties—Reporting.
70.14.165 - Total cost of insulin work group—Authority implementation.