SUBSTITUTE HOUSE BILL 1099
State of Washington
2019 Regular Session
ByHouse Health Care & Wellness (originally sponsored by Representatives Jinkins, Cody, Tharinger, Robinson, and Reeves)
READ FIRST TIME 02/13/19.
AN ACT Relating to providing notice about network adequacy to consumers; and adding a new section to chapter 48.43
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:
(1) Beginning January 1, 2020, a health carrier shall:
(a) Include in its electronic posting of a health plan's provider directory a notation of any behavioral health provider whose practice is closed to new patients. Nothing in this subsection limits or expands the authority of the commissioner to adopt rules regarding provider directories under RCW 48.43.510
(b) Prominently post the information listed in (b)(i) through (v) of this subsection on its web site in an easily understandable format and in a manner that any interested party may obtain the information:
(i) The number of business days within which an enrollee must have access to covered behavioral health services under network access standards adopted by the commissioner;
(ii) Information on actions an enrollee may take if he or she is unable to access covered behavioral health services within the requisite number of business days, including any tools or resources the carrier makes available to enrollees to assist them in finding available providers and information on how to file a complaint with the office of the insurance commissioner;
(iii) Any instances where the commissioner has taken disciplinary action against the health carrier for failing to comply with network access standards for covered behavioral health services;
(iv) A link to the commissioner's report published under subsection (4) of this section; and
(v) Resources for persons who are experiencing a mental health crisis including, but not limited to, information on the national suicide prevention lifeline.
(2) The commissioner shall, by rule, specify a model format for the information required to be posted on a health carrier's web site under subsection (1)(b) of this section.
(3) The commissioner may audit the information a health carrier provides under this section for accuracy.
(4) The commissioner shall annually publish on the commissioner's web site a report on the number of consumer complaints per licensed health carrier the commissioner received in the previous calendar year regarding consumers who were not able to access covered behavioral health services within the time limits established by the commissioner.
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