PREPROPOSAL STATEMENT OF INQUIRY
Subject of Possible Rule Making: The commissioner is considering the amendment of rules governing health plans and carriers under chapter 284-43 WAC and may also add provisions to correct or clarify existing provisions. Amendments to existing managed care rules may include changes to address inconsistencies between the current rules and the Health Insurance Portability and Accountability Act (HIPAA). Among the possible amendments or additions are technical changes to ease reporting requirements, clarification of insurer responsibility for the actions by their health care providers and provider administrators, and provisions addressing insurer responsibility for compliance with state and federal laws affecting health plans.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060, 48.18.120, 48.20.450, 48.20.460, 48.30.010, 48.44.050, 48.46.030, and 48.46.200.
Statutes being implemented: RCW 48.44.020, 48.46.060, and 48.46.090.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The primary purpose for considering new rules is to make corrections to chapter 284-43 WAC and address several issues related to the existing rules. Some provisions of chapter 284-43 WAC may need correction as a consequence of changes in federal and state laws. Finally, new problems have been raised by consumers, by the health care community, and by carriers relating to interpretation and implementation of the rules contained in chapter 284-43 WAC.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The commissioner will consult with other state agencies involved in the development, purchase, and provision of managed health care services to minimize conflict between insurance regulations and other state agency rules on the same or similar subjects.
Process for Developing New Rule: For questions regarding substance of these rules, contact John Conniff, (360) 664-3786 or his Administrative Assistant, Ann Eddy, (360) 586-3111. The commissioner will form small groups comprised of affected parties to develop new rules for managed care plans.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kacy Brandeberry, P.O. Box 40255, Olympia, WA 98504-0255, phone (360) 664-3784, fax (360) 664-2782, Internet KacyB@oic.wa.gov. Deadline for comments July 23, 1999.
June 23, 1999
Robert A. Harkins
Chief Deputy Commissioner