WSR 17-05-024 PERMANENT RULES OFFICE OF FINANCIAL MANAGEMENT [Filed February 7, 2017, 8:57 a.m., effective March 10, 2017]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The purpose of this rule-making proposal relates to the statewide all-payer health care claims database (APCD). Specifically, the rule amendment will change the time period in the definition of "historical data." The rule currently defines historical data as data for the period of January 1, 2011, through December 31, 2015. The end date is being change[d] to "December 31, 2016, or from the start date of the first regular quarterly submission in accordance with the data submission schedule.["]
Originally, WAC 82-75-060 defined "historical data" as data files for the period of January 1, 2011, through December 31, 2015. This period was developed based on the time period in which it was anticipated that the APCD would be implemented. Due to the delay in implementation, it is necessary to put in place a different and more flexible historical data time period.
Citation of Existing Rules Affected by this Order: Amending 1 [WAC 82-75-060].
Statutory Authority for Adoption: Chapter 43.371 RCW.
Adopted under notice filed as WSR 16-24-060 on December 6 [5], 2016.
Changes Other than Editing from Proposed to Adopted Version: There are no changes to the rule that was filed. The CR-102 that was filed with that rule had an incorrect statement regarding the ending date of the rule. The inaccuracy has been corrected in this CR-103, however the rule that was filed with the CR-102 is the same as the rule filed now for adoption.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 1, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 11 [0], Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: February 7, 2017.
Roselyn Marcus
Assistant Director of Legal
and Legislative Affairs
Rules Coordinator
AMENDATORY SECTION (Amending WSR 16-04-068, filed 1/29/16, effective 2/29/16)
WAC 82-75-060 Historical data submission.
(1) The purpose of collecting historical data into the WA-APCD is to permit the systematic analysis of the health care delivery system including evaluation of the effectiveness of the Patient Protection and Affordable Care Act signed into law on March 23, 2010.
(2) The lead organization will provide written notification to the data suppliers when the WA-APCD is ready to accept the submission of historical data. Data suppliers shall submit the historical data within sixty days of notification. Requests for an extension of time to submit historical data shall be made in accordance with WAC 82-75-080(3).
(3) "Historical data" means covered medical services claim files, pharmacy claim files, dental claim files, member eligibility and enrollment data files, and provider data files with necessary identifiers for the period January 1, ((2011)) 2013, through December 31, ((2015)) 2016, or through the end of the quarter immediately prior to the first regular quarterly submission due in accordance with the data submission schedule.
(4) The office may grant an exception to this section and approve the filing of historical data for a period less than the period specified in subsection (3) of this section. ((In no event will an exception be granted for a period beginning later than January 1, 2013.)) Requests for an exception under this subsection shall be made to the lead organization within fifteen calendar days of being notified in accordance with subsection (2) of this section. The lead organization shall make a recommendation to the office as to whether to approve or deny the request. The office may approve the request for good cause.
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