AN ACT Relating to prenatal testing for heritable and congenital disorders; adding a new chapter to Title 70 RCW; adding a new section to chapter 48.21 RCW; adding a new section to chapter 48.44 RCW; adding a new section to chapter 48.46 RCW; adding a new section to chapter 70.54 RCW; providing an effective date; and providing an expiration date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. The legislature finds that the availability and competent utilization of certain prenatal tests for congenital and heritable disorders is crucial to protect the health of both mothers and infants. The legislature further finds that the public health, safety, and welfare will be protected by promoting the performance of these tests and the obtaining of data on the utilization of these tests.

NEW SECTION. Sec. 2. Unless the context clearly requires otherwise the definitions in this section apply throughout this chapter.

(1) "Department" means the department of social and health services.

(2) "Laboratory" means a private or public agency or organization performing prenatal tests for congenital and heritable disorders.

(3) "Prenatal tests" means any test that predicts congenital or heritable disorders which: (a) As determined by the state board of health can by improper utilization clearly harm or endanger the health, safety, or welfare of the public, and the potential harm is easily recognizable and not remote or dependent upon tenuous argument, and (b) are enumerated by the department by rule.

(4) "Secretary" means the secretary of social and health services.

NEW SECTION. Sec. 3. The department shall adopt rules establishing requirements for the reporting and other activities required by this chapter. The department shall adopt rules in accordance with the administrative procedure act, chapter 34.04 RCW. In adopting rules the department shall consult with the prenatal test advisory committee.

NEW SECTION. Sec. 4. (1) The prenatal test advisory committee is formed to advise the department on developing prenatal test reporting rules. The advisory committee shall develop recommendations to address:

(a) Obtaining of data on availability of prenatal tests to all pregnant women without regard to age, race, socio-economic status and geographic location;

(b) Obtaining of data on utilization of prenatal tests by pregnant women in relation to age, race, socio-economic status and geographic location;

(c) Obtaining of data from laboratories performing prenatal tests on volume of tests performed, abnormal test results obtained and fees charged;

(d) Obtaining of data on standardization of prenatal tests offered to pregnant women in regard to laboratory procedures, test result reporting and recommendations for follow-up of abnormal results;

(e) Suggested guidelines to facilitate coordination with existing prenatal testing programs of the department; and

(f) Provision of educational materials to physicians or others licensed to provide prenatal care to women for distribution to women at appropriate times in their pregnancies.

(2) The prenatal test advisory committee shall be appointed by the secretary whose members shall be representative of the following groups:

(a) Obstetricians;

(b) Radiologists;

(d) Pediatricians;

(e) The developmentally disabled; and

(f) Laboratories performing prenatal tests.

(3) The prenatal test advisory committee shall serve at the pleasure of the secretary. Advisory committee members shall be reimbursed for travel expenses as provided in RCW 43.03.050 and 43.03.060.

NEW SECTION. Sec. 5. A new section is added to chapter 70.54 RCW to read as follows:

All persons licensed or certified by the state of Washington to provide prenatal care or to practice medicine shall provide information regarding the use and availability of prenatal tests to all pregnant women in their care within the time limits prescribed by department rules and in accordance with standards established by those rules.

NEW SECTION. Sec. 6. A new section is added to chapter 48.21 RCW to read as follows:

On or after January 1, 1990, every group disability contract entered into or renewed that covers hospital, medical, or surgical expenses on a group basis, and which provides benefits for pregnancy, childbirth, or related medical conditions to enrollees of such groups, shall offer benefits for prenatal diagnosis of congenital disorders of the fetus by means of screening and diagnostic procedures during pregnancy to such enrollees when those services are determined to be medically necessary by the disability contractor in accord with standards set in rule by the board of health. Every group disability contractor shall communicate the availability of such coverage to all group disability contract holders and to all groups with whom they are negotiating.

NEW SECTION. Sec. 7. A new section is added to chapter 48.44 RCW to read as follows:

On or after January 1, 1990, every group health care services contract entered into or renewed that covers hospital, medical, or surgical expenses on a group basis, and which provides benefits for pregnancy, childbirth, or related medical conditions to enrollees of such groups, shall offer benefits for prenatal diagnosis of congenital disorders of the fetus by means of screening and diagnostic procedures during pregnancy to such enrollees when those services are determined to be medically necessary by the health care service contractor in accord with standards set in rule by the board of health. Every group health care services contractor shall communicate the availability of such coverage to all group health care service contract holders and to all groups with whom they are negotiating.

NEW SECTION. Sec. 8. A new section is added to chapter 48.46 RCW to read as follows:

On or after January 1, 1990, every group health maintenance agreement entered into or renewed that covers hospital, medical, or surgical expenses and which provides benefits for pregnancy, childbirth, or related medical conditions to enrollees of such groups, shall offer benefits for prenatal diagnosis of congenital disorders of the fetus by means of screening and diagnostic procedures during pregnancy to such enrollees when those services are determined to be medically necessary by the health maintenance organization in accord with standards set in rule by the board of health: PROVIDED, That such procedures shall be covered only if rendered directly by the health maintenance organization or upon referral by the health maintenance organization. Every group health maintenance organization shall communicate the availability of such coverage to all groups covered and to all groups with whom they are negotiating.

NEW SECTION. Sec. 9. The carrier or provider of any group disability contract, health care services contract or health maintenance agreement shall not cancel, reduce, limit or otherwise alter or change the coverage provided solely on the basis of the result of any prenatal test.

NEW SECTION. Sec. 10. Section 5 of this act shall take effect December 31, 1989.

NEW SECTION. Sec. 11. Sections 1 through 4 of this act shall constitute a new chapter in Title 70 RCW.

NEW SECTION. Sec. 12. Sections 1 through 4 of this act shall expire June 30, 1993, unless extended by law for an additional fixed period of time.