WSR 16-04-043
[Insurance Commissioner Matter No. R 2016-02—Filed January 27, 2016, 2:04 p.m.]
Subject of Possible Rule Making: Prior authorization of medical benefits.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060, 48.43.510, 48.165.0301.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: ESSB 6511 (RCW 48.165.0301), passed during the 2014 legislative session, requires the office of insurance commissioner to adopt recommendations from a OneHealthPort workgroup to streamline the prior authorization process. The initial rule making to adopt the workgroup recommendations was limited to the pharmacy benefit and completed by Matter No. R2014-13. Additional rule making is necessary to adopt the remaining workgroup recommendations and apply the recommended time frames for approval of covered services that fall within the medical benefit. This rule making is limited to adopting the OneHealthPort recommendations.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.
Process for Developing New Rule: Submit written comments by March 8, 2016, to Jim Freeburg,, 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 Jim Freeburg, P.O. Box 40258, Olympia, WA 98504, (360) 725-7170,
January 27, 2016
Mike Kreidler
Insurance Commissioner