Proposed Health Insurance-Related Rules Filed in the State of Washington

 

The following proposed insurance-related Rules were recently filed with the State of Washington’s Code Revisers Office. 

 

Proposed Rules:

Note:  Rulemaking Hearings for the following proposed Rules are scheduled for 9:00 a.m. and 10:00 a.m., respectively, on May 26, 2011 at TR 120, 5000 Capitol Blvd., Tumwater, WA.  The deadline to submit comments on both is May 25.

 

R 2011-04  relating to Boards and Directors of Joint Underwriting Association for Midwifery and Birthing Centers for Malpractice Insurance

• This proposed Rule would allow the Washington Insurance Commissioner to consider changing the composition of the organization’s Board of the Directors

 

R 2011-05 relating to Reporting Statistical Data

• Washington law (RCW 48.19.370) provides that the Washington Insurance Commissioner shall promulgate rules and statistical plans for the reporting of loss and countrywide expense experience to assist in determining whether rating systems filed by insurers comply with rate standards. For some lines of insurance, the information is of limited value in relation to the cost to the insurer of reporting the data to a statistical agent. The proposed Rule would allow the Washington Insurance Commissioner to waive the requirement that data must be reported to a statistical agent in specified instances or lines of insurance.

 

 

Pre-proposal Statement of Inquiry:

R 2011-06 Standards for Coordination of Benefits of Medical Services – Definition of Allowable Expense

(W.A.C. impacted:  284-51-195(1))

Due to recent changes to electronic Health Insurance Portability and Accountability Act (“HIPAA”) claims standards adopted by the U.S. Department of Health and Human Services, effective January 1, 2012, a provision within the current Coordination of Benefits (“COB”) Rule that requires secondary payers to use the highest allowable expense in making their payments may create significant new administrative costs and complexity for health care providers and health carriers.  Thus, the possibility of amending the COB Rule definition of “allowable expense” in a manner that would reduce administrative costs and compliance complexity of the new HIPAA transaction standards, without having a negative impact on consumers/patients, will be explored.

The deadline to submit comments is June 3, 2011. 

 

 

Emergency Rule Making

R 2011-09  Health Plan Open Enrollment for Persons Under Age 19

(W.A.C. impacted:  New sections WAC 284-43-970 through WAC 284-43-985)

• This Emergency Rule would replace an expiring one that implemented federal reforms relating to Affordable Care Act provisions that preclude health carriers and health benefit plans from using preexisting condition exclusions as a factor in coverage or eligibility determinations for persons under age 19. Permanent rulemaking for this matter is scheduled for completion in June 2011.