WSR 14-16-089

PREPROPOSAL STATEMENT OF INQUIRY

[Filed August 5, 2014, 9:20 a.m.]

Subject of Possible Rule Making: Chapter 296-14 WAC, Industrial insurance; chapter 296-20 WAC, Medical aid rules; and chapter 296-21 WAC, Reimbursement policies: Psychiatric services, biofeedback, physical medicine.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 51.04.020 and 51.04.030.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: In 2013, the American Psychiatric Association released the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The department of labor and industries (L&I) is considering adopting rules in order to aid in the implementation and consistent use of new DSM versions within Washington's workers' compensation program.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: Many federal and state health care purchasing agencies will use the DSM-5 for coding diagnoses for mental disorders as referenced in federal HIPAA requirements. Washington's workers' compensation program is not mandated to follow HIPPA [HIPAA] requirements, but does so to be consistent with other payors.

In addition, the DSM-5 represents industry standards for diagnostic criteria for mental disorders. L&I is governed by Title 51 RCW, Washington's Industrial Insurance Act. Implementation of the DSM-5 must be within the limitations of that act. No other state or federal agencies are responsible for interpreting and enforcing the provisions of this act.

Process for Developing New Rule: This rule will be developed in consultation with L&I's major stakeholders and other interested parties. Major stakeholder groups include, but are not limited to: The Industrial Insurance Medical Advisory Committee; the Workers' Compensation Advisory Committee; and the Advisory Committee on Health Care Innovation and Evaluation.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Jami Lifka, L&I, Office of the Medical Director, P.O. Box 44321, Olympia, WA 98504-4321, fax (360) 902-6315, phone (360) 902-4941, e-mail Jami.Lifka@Lni.wa.gov.

August 5, 2014

Joel Sacks

Director