Original Notice.

     Exempt from preproposal statement of inquiry under RCW 34.05.310(4).

     Title of Rule and Other Identifying Information: WAC 246-919-990 Fees and renewal cycles, physician and surgeon and 246-918-990 Physician assistants. Amending impaired physician program surcharge and retired active physician licensing fees to implement 2009 SHB 1765 and 2009 2SHB 1899.

     Hearing Location(s): Department of Health, 101 Israel Road S.E., Town Center 1, Room 163, Tumwater, WA 98501, on July 21, 2009, at 3:00 p.m.

     Date of Intended Adoption: July 21, 2009.

     Submit Written Comments to: Julie Kitten, 243 Israel Road S.E., Tumwater, WA 98504, web site http://www3.doh.wa.gov/policyreview/, fax (360) 236-2795, by July 21, 2009.

     Assistance for Persons with Disabilities: Contact Julie Kitten by July 7, 2009, TTY (800) 833-6388 or 711.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rules increase the annual impaired provider surcharge fee to $50.00 for physicians, surgeons, and physician assistants. The annual surcharge fee is assessed in two-year cycles on each license renewal or new license for practitioners licensed under chapters 18.71 and 18.71A RCW. The proposed rules will also provide for a two-year renewal cycle for retired active physicians to align with the cycle for physicians, and correct the impaired physician program statute cited for physician assistants. In addition, the proposed rules will implement 2SHB 1899 that exempts licensed retired active physicians who reside and practice in Washington from paying all fees except the impaired physician program surcharge.

     Reasons Supporting Proposal: SHB 1765 (chapter 98, Laws of 2009) requires that physicians and physician assistants pay $50.00 per year for the impaired physician program. 2SHB 1899 (chapter 403, Laws of 2009) exempts retired active physicians who reside and practice in Washington from paying all fees except the impaired physician program surcharge. These changes and the housekeeping change require amendments to the fee rules to create accurate rules.

     Statutory Authority for Adoption: RCW 43.70.250 and 43.70.280.

     Statute Being Implemented: RCW 18.71.310, 18.71A.020, 18.71.080, 18.130.250, 43.70.110.

     Rule is not necessitated by federal law, federal or state court decision.

     Name of Proponent: Department of health, governmental.

     Name of Agency Personnel Responsible for Drafting: Dianna Staley, 310 Israel Road S.E., Tumwater, WA, (360) 236-4997; Implementation and Enforcement: Julie Kitten, 243 Israel Road S.E., Tumwater, WA, (360) 236-2757.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. A small business economic impact statement (SBEIS) was not prepared. Under RCW 19.85.025 and 34.05.310 (4)(f), an SBEIS is not required for proposed rules that set or adjust fees or rates pursuant to legislative standards.

     A cost-benefit analysis is not required under RCW 34.05.328. The agency did not complete a cost-benefit analysis under RCW 34.05.328. RCW 34.05.328 (5)(b)(vi) exempts rules that set or adjust fees or rates pursuant to legislative standards.

June 16, 2009

Mary C. Selecky

Secretary of Health

OTS-2430.1

AMENDATORY SECTION(Amending WSR 08-15-014, filed 7/7/08, effective 7/7/08)

WAC 246-918-990   Physician assistants fees and renewal cycle.   (1) Licenses must be renewed every two years on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2. ((The secretary may require payment of renewal fees less than those established in this section if the current level of fees is likely to result in a surplus of funds. Surplus funds are those in excess of the amount necessary to pay for the costs of administering the program and to maintain a reasonable reserve. Notice of any adjustment in the required payment will be provided to practitioners. The adjustment in the required payment shall remain in place for the duration of a renewal cycle to assure practitioners an equal benefit from the adjustment.))

     (2) The applicant or licensee must pay the following nonrefundable fees:

Title of Fee	Fee
Physician assistants((, certified physician assistants, physician assistant-surgical assistants, acupuncture physician assistants)):
Application (annual)*	(($50.00)) $125.00
Two-year renewal*	((70.00)) 220.00
Expired license reissuance	50.00
Duplicate license	15.00
((Impaired physician program surcharge *(assessed at $35.00 on each application and for each year of the renewal period as required in RCW 18.71.310(2))	35.00
UW library fee	25.00))

*Includes: The application or renewal fee, the Washington physician health program surcharge (RCW 18.71A.020(3)) assessed at $50.00 per year, and the fee to access the University of Washington (UW) HEAL-WA web site (RCW 43.70.110) assessed at $25.00 per year.

[Statutory Authority: RCW 43.70.110, 43.70.250, 2008 c 329. 08-15-014, § 246-918-990, filed 7/7/08, effective 7/7/08. Statutory Authority: RCW 43.70.250. 06-11-167, § 246-918-990, filed 5/24/06, effective 7/1/06. Statutory Authority: RCW 43.70.250, [43.70.]280 and 43.70.110. 05-12-012, § 246-918-990, filed 5/20/05, effective 7/1/05. Statutory Authority: RCW 18.71.017, 18.71A.020 and 43.70.280. 02-05-009, § 246-918-990, filed 2/8/02, effective 3/11/02. Statutory Authority: RCW 18.71.017, 18.130.050(1), 18.130.040(4), 18.130.050(12) and 18.130.340. 99-23-090, § 246-918-990, filed 11/16/99, effective 1/1/00. Statutory Authority: RCW 18.71.017 and 18.71A.020(3). 99-13-087, § 246-918-990, filed 6/14/99, effective 7/15/99. Statutory Authority: RCW 43.70.280. 98-05-060, § 246-918-990, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.71.017 and 18.71A.020. 96-03-073, § 246-918-990, filed 1/17/96, effective 2/17/96. Statutory Authority: RCW 43.70.040. 91-06-027 (Order 131), § 246-918-990, filed 2/26/91, effective 3/29/91.]

OTS-2431.1

AMENDATORY SECTION(Amending WSR 08-15-014, filed 7/7/08, effective 7/7/08)

WAC 246-919-990   Physician and surgeon fees and renewal cycle.   (1) Licenses must be renewed every two years on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2, except postgraduate training limited licenses ((and retired active physician licenses. The secretary may require payment of renewal fees less than those established in this section if the current level of fees is likely to result in a surplus of funds. Surplus funds are those in excess of the amount necessary to pay for the costs of administering the program and to maintain a reasonable reserve. Notice of any adjustment in the required payment will be provided to practitioners. The adjustment in the required payment shall remain in place for the duration of a renewal cycle to assure practitioners an equal benefit from the adjustment)).

     (2) Postgraduate training limited licenses must be renewed every year to correspond to the program's date. ((The secretary may require payment of renewal fees less than those established in this section if the current level of fees is likely to result in a surplus of funds. Surplus funds are those in excess of the amount necessary to pay for the costs of administering the program and to maintain a reasonable reserve. Notice of any adjustment in the required payment will be provided to practitioners. The adjustment in the required payment shall remain in place for the duration of a renewal cycle to assure practitioners an equal benefit from the adjustment.))

     (3) A retired active physician ((licenses shall be renewed every year. The secretary may require payment of renewal fees less than those established in this section if the current level of fees is likely to result in a surplus of funds. Surplus funds are those in excess of the amount necessary to pay for the costs of administering the program and to maintain a reasonable reserve. Notice of any adjustment in the required payment will be provided to practitioners. The adjustment in the required payment shall remain in place for the duration of a renewal cycle to assure practitioners an equal benefit from the adjustment)) who resides and practices in Washington and obtains or renews a retired active license is exempt from all licensing fees except for the impaired physician program surcharge authorized by RCW 18.71.310.

     (4) The applicants and licensees must pay the following nonrefundable fees:

Title of Fee	Fee
Physicians and surgeons: Chapter 18.71 RCW
Application (annual)*	(($425.00)) $500.00
((Retired active physician license renewal*	100.00))
((Retired active late renewal penalty	50.00))
Two-year renewal*	((525.00)) 675.00
Late renewal penalty	262.50
Expired license reissuance	262.50
Certification of license	50.00
Duplicate license	15.00
Temporary permit	50.00
Application fee for transitioning from a postgraduate training limited license (annual)*	((100.00)) 175.00
Retired active physicians and surgeons: (Two-year cycle)
Retired active physician who resides and practices in-state per RCW 18.71.080 and 18.130.250 (Washington physician health program surcharge)	100.00
Retired active physician license renewal*(does not meet in-state exemption)	350.00
Retired active late renewal penalty	50.00
Postgraduate limited license fees: RCW 18.71.095 (One-year cycle)
Limited license application*	((325.00)) 400.00
Limited license renewal*	((325.00)) 400.00
Limited duplicate license	15.00
((Impaired physician program *(assessed at $35.00 on each application and for each year of the renewal period as required in RCW 18.71.310(2))	35.00
UW library fee	25.00))

*Includes: The application or renewal fee, the Washington physician health program surcharge (RCW 18.71A.020(3)) assessed at $50.00 per year, and the fee to access the University of Washington (UW) HEAL-WA web site (RCW 43.70.110) assessed at $25.00 per year.

[Statutory Authority: RCW 43.70.110, 43.70.250, 2008 c 329. 08-15-014, § 246-919-990, filed 7/7/08, effective 7/7/08. Statutory Authority: RCW 43.70.250. 06-11-167, § 246-919-990, filed 5/24/06, effective 7/1/06. Statutory Authority: RCW 43.70.250, [43.70.]280 and 43.70.110. 05-12-012, § 246-919-990, filed 5/20/05, effective 7/1/05. Statutory Authority: RCW 18.71.017, 18.71A.020 and 43.70.280. 02-05-009, § 246-919-990, filed 2/8/02, effective 3/11/02. Statutory Authority: RCW 18.71.017, 18.130.050(1), 18.130.040(4), 18.130.050(12) and 18.130.340. 99-23-090, § 246-919-990, filed 11/16/99, effective 1/1/00. Statutory Authority: RCW 43.70.280. 98-05-060, § 246-919-990, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.71.017 and 43.70.250. 97-15-100, § 246-919-990, filed 7/21/97, effective 8/21/97. Statutory Authority: RCW 18.71.017 and 18.71A.020. 96-03-073, § 246-919-990, filed 1/17/96, effective 2/17/96.]

© Washington State Code Reviser's Office