S-2119.1  _______________________________________________

                    SUBSTITUTE SENATE BILL 5313

          _______________________________________________

State of Washington      56th Legislature     1999 Regular Session

By Senate Committee on Health & Long‑Term Care (originally sponsored by Senators Wojahn, Zarelli, Thibaudeau, Deccio and Winsley)

Read first time 03/03/1999.

Limiting the scope of mental health record audits.

    AN ACT Relating to the scope of mental health record audits; and adding a new section to chapter 48.43 RCW.

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

NEW SECTION. Sec. 1.  A new section is added to chapter 48.43 RCW to read as follows:

    Every health carrier that provides coverage for any outpatient mental health service shall comply with the following requirements:

    (1) In performing a utilization review of mental health services for a specific enrollee, the utilization review is limited to accessing only the specific health care information contained in the enrollee's record.

    (2) In performing an audit of a provider that has furnished mental health services to a carrier's enrollees, the audit is limited to accessing only the records of enrollees covered by the specific health carrier for which the audit is being performed, except as otherwise permitted by RCW 70.02.050 and 71.05.630.

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