WSR 14-07-103
[Insurance Commissioner Matter No. R 2014-03—Filed March 19, 2014, 7:21 a.m.]
Subject of Possible Rule Making: Essential health benefit categories (EHB), transplant waiting period.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060 and 48.43.715.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The Patient Protection and Affordable Care Act (ACA) established federal standards for the EHB that must be offered by nongrandfathered individual and small group health plans. The ACA also prohibits exclusion or limitations on benefits on the basis of a preexisting condition or other discriminatory bases.
Under this rule making, the commissioner will review the waiting period for transplant services, supplies, and treatment currently permitted as an optional limitation under the state's rules implementing the EHB in WAC 284-43-878 to ensure conformance with applicable federal law for plan years on or after January 1, 2015.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None. In conjunction with other federal agencies, the United States Department of Health and Human Services (HHS) implements the ACA through regulation and guidance. HHS permits states to designate and regulate their essential health benefits packages in accordance with federal law. This rule will be coordinated with HHS by monitoring HHS published requirements and guidance associated with the topic.
Process for Developing New Rule: Submit written comments by April 21, 2014, to Kacy Scott, P.O. Box 40258, Olympia, WA 98504-0258,, fax (360) 586-3109.
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 40258, Olympia, WA 98504-0258,, fax (360) 586-3109.
March 19, 2014
Mike Kreidler
Insurance Commissioner