WSR 22-13-182
PREPROPOSAL STATEMENT OF INQUIRY
OFFICE OF THE
INSURANCE COMMISSIONER
[Insurance Commissioner Matter R 2022-06—Filed June 22, 2022, 10:52 a.m.]
Subject of Possible Rule Making: General filing instructions for carrier submission of provider agreements and health care benefit manager (HCBM) contracts.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: Requirements for the submission of provider agreements were originally placed in the Washington state SERFF health and disability form filing general instructions. At that time, the health forms unit at the office of the insurance commissioner (OIC) reviewed both health forms and provider agreements. Now the subject matter expertise for review of provider agreements is located in the provider network oversight program at OIC, and most carriers have a separate team for submission of these agreements, which have different filing requirements than health forms. Due to legislation passed in 2020 (2SSB 5601), carriers are also now required to file HCBM contracts, which include provider network management and other services that direct provider activity. The subject matter expertise for the review of HCBM contracting is located in the provider network oversight program that reviews provider agreements at OIC. Health carriers similarly have units that specialize in these types of agreements and contracting arrangements. This rule will amend existing rules to establish unique general filing instructions for the submission of provider agreements and HCBM contracts by carriers.
Process for Developing New Rule: Submit comments by July 15, 2022.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Shari Maier, 302 Sid Snyder Avenue S.W., Olympia, WA 98504, phone 360-725-7173, fax 360-586-3109, TTY 360-586-0241, email rulescoordinator@oic.wa.gov, website www.insurance.wa.gov.
June 22, 2022
Mike Kreidler
Insurance Commissioner