WAS INS Consolidated Healthcare Rule

On Jun. 4, WAS INS proposed rule on telemedicine, behavioral health.

  • WAS INS issued preproposal statement of inquiry on consolidated healthcare rule.
  • Aims to implement SB 5300 on drug coverage (#172202), HB 2041 on physical assistant), SB 5821 on telemedicine, HD 1957 on preventative coverage, #206749.
  • Telemedicine Coverage
  • SB 5821 (HB 1881) established a uniform standard for creating an established relationship for coverage of audio-only telemedicine services; effective Jun. 6, 2024.
  • Health plans required to cover telemedicine services for audio-only telemedicine services if the covered person has an established relationship with the provider.
  • Amended established relationship definition to create a single definition for all services.
  • Rulemaking Provisions
  • Rules would clarify prescription drug coverage for behavioral health treatment.
  • Update reimbursement and collaboration requirements related to physician assistant.
  • Revise established relationship definition as applied to audio-only telemedicine services
  • Additionally, clarify coverage and cost-sharing requirements for preventive services.
  • Amend WAS INS 284-43 (health carriers) and WAS INS 284-170 (plan management).
  • Consultation
  • Comments on preproposal must be submitted by Jul. 5, 2024.
  • Jun. 2024 WAS INS Consolidated Healthcare
  • On Jun. 14, 2024, WAS INS certified preproposal, published in Washington Register.
  • Oct. 2024 WAS INS Proposed Rule
  • On Oct. 11, 2024, WAS INS published proposed rule on consolidated healthcare rule.
  • Hearing is scheduled for Nov. 7, 2024; comments may be filed until Nov. 8, 2024.
  • The State's anticipated adoption date of the proposed rules is Nov. 18, 2024.
  • Dec. 2024 WAS INS Permanent Rule
  • On Dec. 13, 2024, WAS INS issued permanent rule, becomes effective Dec. 28, 2024.

Regulators WAS INS
Entity Types Ins
Reference WAS SR No. 24-24, RF WSR 24-24-067, 12/13/2024; RF WSR 24-20-133, 10/11/2024; RF WSR 24-12-075, R2024-05, 6/4/2024; Bill HB1881, SB5821, HB2041; Citation: *WAS INS* 284-43, 284-170;
Functions Claims/Accelerated Benefits; Compliance; Legal; Operations; Product Administration; Reporting
Countries United States of America
Category
State
Products Insurance; Insurance-Health
Regions Am
Rule Type Final
Rule Date 6/4/2024
Effective Date 12/28/2024
Rule Id 214826
Linked to Rule :206749
Reg. Last Update 12/13/2024
Report Section US Insurance

Last substantive update on 12/18/2024