WSR 08-12-099

PREPROPOSAL STATEMENT OF INQUIRY

OFFICE OF

INSURANCE COMMISSIONER

[ Insurance Commissioner Matter No. R 2008-20 -- Filed June 4, 2008, 9:14 a.m. ]

Subject of Possible Rule Making: Amending chapter 284-51 WAC regulating standards for coordination of benefits (COB), including WAC 284-51-215 and 284-51-260 regulating the obligation of a secondary plan to make estimated plan payments to providers. The office of insurance commissioner is also considering whether to adopt additional requirements or incentives for prompt COB processing, and more effective consumer protections against inappropriate billings in COB situations.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060, 48.21.200, 48.44.050, and 48.46.200.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: Concerns have been raised that the requirement that a secondary plan make an estimated payment to a provider creates significant administrative complexity and workload for both plans and providers. The commissioner will consider whether the elimination of the estimated payment requirement would be of benefit to providers, and would not harm consumers.

The commissioner will also consider whether other changes should be made to promote more timely and efficient coordination of benefits and to establish protections against inappropriate patient billings in COB situations.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.

Process for Developing New Rule: Input and suggestions will be requested from interested parties, including the Washington healthcare forum business and technology work group. Written comments should be submitted by July 18, 2008, to Kacy Scott, P.O. Box 40255, Olympia, WA 98504-0258 [98504-0255], fax (360) 586-3109, e-mail KacyS@oic.wa.gov.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kacy Scott, P.O. Box 40255, Olympia, WA 98504-0258 [98504-0255], fax (360) 586-3109, e-mail KacyS@oic.wa.gov.

June 4, 2008

Mike Kreidler

Insurance Commissioner

Washington State Code Reviser's Office