WSR 19-08-090
PROPOSED RULES
DEPARTMENT OF HEALTH
[Filed April 3, 2019, 10:17 a.m.]
Original Notice.
Title of Rule and Other Identifying Information: WAC 246-919-990 Physician and surgeon fees and renewal cycle and 246-918-990 Physician assistant fees and renewal cycle, proposing to increase renewal fees and late renewal penalties for allopathic physicians and allopathic physician assistants.
Hearing Location(s): On May 7, 2019, at 2:00 p.m., at the Department of Health, Town Center 2, Room #158, 111 Israel Road S.E., Tumwater, WA 98501.
Date of Intended Adoption: May 17, 2019.
Submit Written Comments to: Nancy Elliott, Department of Health, P.O. Box 47850, Olympia, WA 98504-7850, email https://fortress.wa.gov/doh/policyreview, by May 7, 2019.
Assistance for Persons with Disabilities: Contact Nancy Elliott, phone 360-236-4878, TTY 360-833-6388 or 711, email nancy.elliott@doh.wa.gov, by April 24, 2019.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Current fees are not generating sufficient revenue to keep the program self-supporting, with the fund balance projected to fall into a deficit of nearly -$9 million next biennium. The department of health (department), in coordination with the Washington Medical Commission (WMC), is proposing fee increases to bring licensing revenues in alignment with the actual costs of regulating allopathic physicians and physician assistants, maintain a positive program fund balance, and bring the reserve to an amount equal to five months of operating costs over a six year period. Professions need to maintain a reserve that is based on level of risk including revenue stability, disciplinary trends, and size of the profession, in order to cover unanticipated costs.
Department policy and office of financial management guidelines that require professions to have a sufficient reserve to cover unexpected costs were also used.
The department is also proposing adjustments to bring the late renewal penalty in line with agency standards for health professions.
Reasons Supporting Proposal: RCW
43.70.250 requires the cost of each licensing program to be fully borne by the profession's members, and licensing fees to be based on the licensing program's costs. Without the proposed fee increases, the program cannot remain self-supporting. In addition, the state auditor's office published their performance audit report, "Aligning Healthcare Professional Fees with Licensing Costs," in November 2018, to examine if the department aligns the fees it charges to health care professions with the costs of licensing. In response, the department is developing processes to review fees more consistently and enhance transparency of fund balances and fee-setting.
The program's budget is not currently maintaining a positive fund balance, which is projected to fall into a large deficit next biennium, nor a reserve equal to five months of operating costs to cover extraordinary expenditures. The financial risks, due to unexpected costs associated with ongoing multiple legal challenges in state and federal courts that could settle against WMC, necessitate a larger reserve.
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: Nancy Elliott, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-4878; Implementation and Enforcement: Amelia Boyd, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-2727.
A school district fiscal impact statement is not required under RCW
28A.305.135.
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.
This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:
Is exempt under RCW
19.85.025(3) as the rules set or adjust fees under the authority of RCW
19.02.075 or that set or adjust fees or rates pursuant to legislative standards, including fees set or adjusted under the authority of RCW
19.80.045.
April 3, 2019
John Wiesman, DrPH, MPH
Secretary
AMENDATORY SECTION(Amending WSR 15-20-050, filed 9/30/15, effective 1/1/16)
WAC 246-918-990Physician 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.
(2) The applicant or licensee must pay the following nonrefundable fees:
Title of Fee | Fee |
Physician assistants: |
Original application (((annual)* | $116.00)) |
| Application | $50.00 |
| UW HEAL-WA surcharge* | 16.00 |
| Washington physician health program surcharge | 50.00 |
Active license renewal | |
| Two-year renewal((* | 202.00)) 265.00 |
| UW HEAL-WA surcharge* | 32.00 |
| Washington physician health program surcharge* | 100.00 |
| Late renewal fee | ((50.00)) 130.00 |
| Expired license reissuance | 50.00 |
Retired active license renewal | |
| Two-year renewal((** | 135.00)) 35.00 |
| Washington physician health program surcharge* | 100.00 |
| Late renewal fee | 35.00 |
Duplicate license | 15.00 |
* | (( Includes)) The Washington physician health program surcharge (RCW 18.71A.020(3)) is assessed at $50.00 per year, and the University of Washington (UW) HEAL-WA web portal access fee (RCW 43.70.110) assessed at $16.00 per year. |
** | ((Includes))The Washington physician health program surcharge is assessed at $50.00 per year. |
AMENDATORY SECTION(Amending WSR 12-19-088, filed 9/18/12, effective 11/1/12)
WAC 246-919-990Physician 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.
(2) Postgraduate training limited licenses must be renewed every year to correspond to the program's date.
(3) A retired active physician 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)* | $491.00 |
Two-year renewal* | 657.00 |
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)* | 166.00 |
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) | 332.00 |
Retired active late renewal penalty | 50.00 |
Postgraduate limited license fees: RCW 18.71.095 (One-year cycle) | |
Limited license application* | 391.00 |
Limited license renewal* | 391.00 |
Limited duplicate license | 15.00)) |
Title of Fee | Fee |
Original application | |
| Application | $425.00 |
| UW HEAL-WA surcharge* | 16.00 |
| Washington physician health program surcharge* | 50.00 |
Active license renewal | |
| Two-year renewal | 880.00 |
| UW HEAL-WA surcharge* | 32.00 |
| Washington physician health program surcharge* | 100.00 |
| Late renewal penalty | 300.00 |
| Expired license reissuance | 262.50 |
Retired active license renewal | |
| Two-year renewal (only includes Washington physician health program surcharge)** | 100.00 |
Retired active license renewal (does not meet in-state exemption) | |
| Two-year renewal | 200.00 |
| UW HEAL-WA surcharge* | 32.00 |
| Washington physician health program surcharge* | 100.00 |
| Late renewal penalty | 100.00 |
Verification of license | 50.00 |
Duplicate license | 15.00 |
Temporary permit | 50.00 |
Transitioning from postgraduate training limited license | |
| Application fee | 100.00 |
| UW HEAL-WA surcharge* | 16.00 |
| Washington physician health program surcharge* | 50.00 |
(One-year cycle) | |
Original application | |
| Application | 325.00 |
| UW HEAL-WA surcharge* | 16.00 |
| Washington physician health program surcharge* | 50.00 |
Limited license renewal (One-year cycle) | |
| Renewal | 325.00 |
| UW HEAL-WA surcharge* | 16.00 |
| Washington physician health program surcharge* | 50.00 |
| Limited duplicate license | 15.00 |
* | (( The application or renewal fee includes:)) The Washington physician health program surcharge (RCW 18.71.310(2)) is assessed at $50.00 per year, and the University of Washington (UW) HEAL-WA web portal access fee (RCW 43.70.110) is assessed at $16.00 per year. |