AN ACT
Relating to quality assurance; amending RCW 43.70.510 and 43.72.310; amending
1995 c . . . (ESHB 1046) s 27 (uncodified); reenacting and amending
RCW 42.17.310; adding new sections to chapter 43.70 RCW; adding a new section
to chapter 43.72 RCW; creating new sections; repealing RCW 70.170.100,
70.170.110, 70.170.120, 70.170.130, 70.170.140, 43.72.070, and 70.170.080;
providing an effective date; and declaring an emergency.
BE IT ENACTED BY THE LEGISLATURE
OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1. HOSPITAL
DISCHARGE DATA‑-OTHER DATA REQUIREMENTS. (1) To promote
the public interest consistent with the purposes of chapter 492, Laws of 1993
as amended by chapter . . ., Laws of 1995 (this act), the department
shall continue to require hospitals to submit hospital financial and patient
discharge information, which shall be collected, maintained, analyzed, and
disseminated by the department. The department shall, if deemed cost-effective
and efficient, contract with a private entity for any or all parts of data
collection. Data elements shall be reported in conformance with a uniform
reporting system established by the department. This includes data elements
identifying each hospital's revenues, expenses, contractual allowances, charity
care, bad debt, other income, total units of inpatient and outpatient services,
and other financial information reasonably necessary to fulfill the purposes of
this section. Data elements relating to use of hospital services by patients
shall be the same as those currently compiled by hospitals through inpatient
discharge abstracts. The department shall encourage and permit reporting by
electronic transmission or hard copy as is practical and economical to
reporters.
(2) In
identifying financial reporting requirements, the department may require both
annual reports and condensed quarterly reports from hospitals, so as to achieve
both accuracy and timeliness in reporting, but shall craft such requirements
with due regard of the data reporting burdens of hospitals.
(3)
The health care data collected, maintained, and studied by the department shall
only be available for retrieval in original or processed form to public and
private requestors and shall be available within a reasonable period of time
after the date of request. The cost of retrieving data for state officials and
agencies shall be funded through the state general appropriation. The cost of
retrieving data for individuals and organizations engaged in research or
private use of data or studies shall be funded by a fee schedule developed by
the department that reflects the direct cost of retrieving the data or study in
the requested form.
(4)
The department shall, in consultation and collaboration with the federally
recognized tribes, urban or other Indian health service organizations, and the
federal area Indian health service, design, develop, and maintain an American
Indian-specific health data, statistics information system. The department
rules regarding confidentiality shall apply to safeguard the information from
inappropriate use or release.
(5)
All persons subject to the data collection requirements of this section shall
comply with departmental requirements established by rule in the acquisition of
data.
NEW
SECTION. Sec. 2. DATA
STANDARDS. (1) To promote the public interest consistent with this act, the
department of health, in cooperation with the health care policy board and the
information services board established under RCW 43.105.032, shall develop
health care data standards to be used by, and developed in collaboration with,
consumers, purchasers, health carriers, providers, and state government as
consistent with the intent of chapter 492, Laws of 1993 as amended by chapter
. . ., Laws of 1995 (this act), to promote the delivery of quality
health services that improve health outcomes for state residents. The data
standards shall include content, coding, confidentiality, and transmission
standards for all health care data elements necessary to support the intent of
this section, and to improve administrative efficiency and reduce cost.
Purchasers, as allowed by federal law, health carriers, health facilities and
providers as defined in chapter 48.43 RCW, and state government shall utilize
the data standards. The information and data elements shall be reported as the
department of health directs by rule in accordance with data standards
developed under this section.
(2)
The health care data collected, maintained, and studied by the department under
this section, the health care policy board, or any other entity: (a) Shall include
a method of associating all information on health care costs and services with
discrete cases; (b) shall not contain any means of determining the personal
identity of any enrollee, provider, or facility; (c) shall only be available
for retrieval in original or processed form to public and private requesters;
(d) shall be available within a reasonable period of time after the date of
request; and (e) shall give strong consideration to data standards that achieve
national uniformity.
(3)
The cost of retrieving data for state officials and agencies shall be funded
through state general appropriation. The cost of retrieving data for
individuals and organizations engaged in research or private use of data or
studies shall be funded by a fee schedule developed by the department that
reflects the direct cost of retrieving the data or study in the requested form.
(4)
All persons subject to this section shall comply with departmental requirements
established by rule in the acquisition of data, however, the department shall
adopt no rule or effect no policy implementing the provisions of this section
without an act of law.
(5)
The department shall submit developed health care data standards to the
appropriate committees of the legislature by December 31, 1995.
NEW
SECTION. Sec. 3. HEALTH
CARE QUALITY‑-FINDINGS AND INTENT. The legislature finds that it is
difficult for consumers of health care services to determine the quality of
health care prior to purchase or utilization of medical care. The legislature
also finds that accountability is a key component in promoting quality
assurance and quality improvement throughout the health care delivery system,
including public programs. Quality assurance and improvement standards are necessary
to promote the public interest, contribute to cost efficiencies, and improve
the ability of consumers to ascertain quality health care purchases.
The
legislature intends to have consumers, health carriers, health care providers
and facilities, and public agencies participate in the development of quality
assurance and improvement standards that can be used to develop a uniform
quality assurance program for use by all public and private health plans,
providers, and facilities. To that end, in conducting the study required under
section 4 of this act, the department of health shall:
(1)
Consider the needs of consumers, employers, health care providers and
facilities, and public and private health plans;
(2)
Take full advantage of existing national standards of quality assurance to
extend to middle-income populations the protections required for state
management of health programs for low-income populations;
(3)
Consider the appropriate minimum level of quality assurance standards that
should be disclosed to consumers and employers by health care providers and
facilities, and public and private health plans; and
(4)
Consider standards that permit health care providers and facilities to share
responsibility for participation in a uniform quality assurance program.
NEW
SECTION. Sec. 4. UNIFORM
QUALITY ASSURANCE. (1) The department of health in consultation with the
health policy board shall study the feasibility of a uniform quality assurance
and improvement program for use by all public and private health plans and
health care providers and facilities. In this study, the department shall
consult with:
(a)
Public and private purchasers of health care services;
(b)
Health carriers;
(c)
Health care providers and facilities; and
(d)
Consumers of health services.
(2) In
conducting the study, the department shall propose standards that meet the
needs of affected persons and organizations, whether public or private, without
creation of differing levels of quality assurance. All consumers of health
services should be afforded the same level of quality assurance.
(3) At
a minimum, the study shall include but not be limited to the following program
components and indicators appropriate for consumer disclosure:
(a)
Health care provider training, credentialing, and licensure standards;
(b)
Health care facility credentialing and recredentialing;
(c)
Staff ratios in health care facilities;
(d)
Annual mortality and morbidity rates of cases based on a defined set of
procedures performed or diagnoses treated in health care facilities, adjusted
to fairly consider variable factors such as patient demographics and case
severity;
(e)
The average total cost and average length of hospital stay for a defined set of
procedures and diagnoses;
(f)
The total number of the defined set of procedures, by specialty, performed by
each physician at a health care facility within the previous twelve months;
(g)
Utilization performance profiles by provider, both primary care and specialty
care, that have been adjusted to fairly consider variable factors such as
patient demographics and severity of case;
(h)
Health plan fiscal performance standards;
(i)
Health care provider and facility recordkeeping and reporting standards;
(j)
Health care utilization management that monitors trends in health service
under-utilization, as well as over-utilization of services;
(k)
Health monitoring that is responsive to consumer, purchaser, and public health
assessment needs; and
(l)
Assessment of consumer satisfaction and disclosure of consumer survey results.
(4) In
conducting the study, the department shall develop standards that permit each
health care facility, provider group, or health carrier to assume responsibility
for and determine the physical method of collection, storage, and assimilation
of quality indicators for consumer disclosure. The study may define the forms,
frequency, and posting requirements for disclosure of information.
In
developing proposed standards under this subsection, the department shall
identify options that would minimize provider burden and administrative cost
resulting from duplicative private sector data submission requirements.
(5)
The department shall submit a preliminary report to the legislature by December
31, 1995, including recommendations for initial legislation pursuant to
subsection (6) of this section, and shall submit supplementary reports and
recommendations as completed, consistent with appropriated funds and staffing.
(6)
The department shall not adopt any rule implementing the uniform quality
assurance program or consumer disclosure provisions unless expressly directed
to do so by an act of law.
NEW
SECTION. Sec. 5. QUALITY
ASSURANCE‑-INTERAGENCY COOPERATION‑-ELIMINATION AND COORDINATION OF
DUPLICATE STATE PROGRAMS. No later than July 1, 1995, the health care policy
board together with the department of health, the health care authority, the
department of social and health services, the office of the insurance
commissioner, and the department of labor and industries shall form an
interagency group for coordination and consultation on quality assurance
activities and collaboration on final recommendations for the study required
under section 4 of this act. By December 31, 1996, the group shall review all
state agency programs governing health service quality assurance, in light of
legislative actions pursuant to section 4(6) of this act, and shall recommend
to the legislature, the consolidation, coordination, or elimination of rules
and programs that would be made unnecessary pursuant to the development of a
uniform quality assurance and improvement program.
Sec.
6. RCW
42.17.310 and 1994 c 233 s 2 and 1994 c 182 s 1 are each reenacted and amended
to read as follows:
RECORDS
EXEMPT FROM PUBLIC INSPECTION‑-MODIFIED. (1) The following are exempt
from public inspection and copying:
(a)
Personal information in any files maintained for students in public schools,
patients or clients of public institutions or public health agencies, or
welfare recipients.
(b)
Personal information in files maintained for employees, appointees, or elected
officials of any public agency to the extent that disclosure would violate
their right to privacy.
(c)
Information required of any taxpayer in connection with the assessment or
collection of any tax if the disclosure of the information to other persons
would (i) be prohibited to such persons by RCW 82.32.330 or (ii) violate the
taxpayer's right to privacy or result in unfair competitive disadvantage to the
taxpayer.
(d)
Specific intelligence information and specific investigative records compiled
by investigative, law enforcement, and penology agencies, and state agencies
vested with the responsibility to discipline members of any profession, the
nondisclosure of which is essential to effective law enforcement or for the
protection of any person's right to privacy.
(e)
Information revealing the identity of persons who are witnesses to or victims
of crime or who file complaints with investigative, law enforcement, or
penology agencies, other than the public disclosure commission, if disclosure
would endanger any person's life, physical safety, or property. If at the time
a complaint is filed the complainant, victim or witness indicates a desire for
disclosure or nondisclosure, such desire shall govern. However, all complaints
filed with the public disclosure commission about any elected official or
candidate for public office must be made in writing and signed by the
complainant under oath.
(f)
Test questions, scoring keys, and other examination data used to administer a
license, employment, or academic examination.
(g)
Except as provided by chapter 8.26 RCW, the contents of real estate appraisals,
made for or by any agency relative to the acquisition or sale of property,
until the project or prospective sale is abandoned or until such time as all of
the property has been acquired or the property to which the sale appraisal
relates is sold, but in no event shall disclosure be denied for more than three
years after the appraisal.
(h)
Valuable formulae, designs, drawings, and research data obtained by any agency
within five years of the request for disclosure when disclosure would produce
private gain and public loss.
(i)
Preliminary drafts, notes, recommendations, and intra-agency memorandums in
which opinions are expressed or policies formulated or recommended except that
a specific record shall not be exempt when publicly cited by an agency in
connection with any agency action.
(j)
Records which are relevant to a controversy to which an agency is a party but
which records would not be available to another party under the rules of
pretrial discovery for causes pending in the superior courts.
(k)
Records, maps, or other information identifying the location of archaeological
sites in order to avoid the looting or depredation of such sites.
(l)
Any library record, the primary purpose of which is to maintain control of
library materials, or to gain access to information, which discloses or could
be used to disclose the identity of a library user.
(m)
Financial information supplied by or on behalf of a person, firm, or
corporation for the purpose of qualifying to submit a bid or proposal for (i) a
ferry system construction or repair contract as required by RCW 47.60.680
through 47.60.750 or (ii) highway construction or improvement as required by
RCW 47.28.070.
(n)
Railroad company contracts filed prior to July 28, 1991, with the utilities and
transportation commission under RCW 81.34.070, except that the summaries of the
contracts are open to public inspection and copying as otherwise provided by
this chapter.
(o)
Financial and commercial information and records supplied by private persons
pertaining to export services provided pursuant to chapter 43.163 RCW and
chapter 53.31 RCW.
(p)
Financial disclosures filed by private vocational schools under chapter 28C.10
RCW.
(q)
Records filed with the utilities and transportation commission or attorney
general under RCW 80.04.095 that a court has determined are confidential under
RCW 80.04.095.
(r)
Financial and commercial information and records supplied by businesses or
individuals during application for loans or program services provided by
chapters 43.163, 43.160, 43.330, and 43.168 RCW, or during application for
economic development loans or program services provided by any local agency.
(s)
Membership lists or lists of members or owners of interests of units in
timeshare projects, subdivisions, camping resorts, condominiums, land
developments, or common-interest communities affiliated with such projects,
regulated by the department of licensing, in the files or possession of the
department.
(t)
All applications for public employment, including the names of applicants,
resumes, and other related materials submitted with respect to an applicant.
(u)
The residential addresses and residential telephone numbers of employees or
volunteers of a public agency which are held by the agency in personnel
records, employment or volunteer rosters, or mailing lists of employees or
volunteers.
(v)
The residential addresses and residential telephone numbers of the customers of
a public utility contained in the records or lists held by the public utility
of which they are customers.
(w)(i)
The federal social security number of individuals governed under chapter 18.130
RCW maintained in the files of the department of health, except this exemption
does not apply to requests made directly to the department from federal, state,
and local agencies of government, and national and state licensing,
credentialing, investigatory, disciplinary, and examination organizations; (ii)
the current residential address and current residential telephone number of a
health care provider governed under chapter 18.130 RCW maintained in the files
of the department, if the provider requests that this information be withheld
from public inspection and copying, and provides to the department an accurate
alternate or business address and business telephone number. On or after
January 1, 1995, the current residential address and residential telephone
number of a health care provider governed under RCW 18.130.140 maintained in
the files of the department shall automatically be withheld from public
inspection and copying if the provider has provided the department with an
accurate alternative or business address and telephone number.
(x)
Information obtained by the board of pharmacy as provided in RCW 69.45.090.
(y)
Information obtained by the board of pharmacy or the department of health and
its representatives as provided in RCW 69.41.044, 69.41.280, and 18.64.420.
(z)
Financial information, business plans, examination reports, and any information
produced or obtained in evaluating or examining a business and industrial
development corporation organized or seeking certification under chapter 31.24
RCW.
(aa)
Financial and commercial information supplied to the state investment board by
any person when the information relates to the investment of public trust or
retirement funds and when disclosure would result in loss to such funds or in
private loss to the providers of this information.
(bb)
Financial and valuable trade information under RCW 51.36.120.
(cc)
Client records maintained by an agency that is a domestic violence program as
defined in RCW 70.123.020 or 70.123.075 or a rape crisis center as defined in
RCW 70.125.030.
(dd)
Information that identifies a person who, while an agency employee: (i) Seeks
advice, under an informal process established by the employing agency, in order
to ascertain his or her rights in connection with a possible unfair practice
under chapter 49.60 RCW against the person; and (ii) requests his or her
identity or any identifying information not be disclosed.
(ee)
Investigative records compiled by an employing agency conducting a current
investigation of a possible unfair practice under chapter 49.60 RCW or of a
possible violation of other federal, state, or local laws prohibiting
discrimination in employment.
(ff)
Business related information protected from public inspection and copying under
RCW 15.86.110.
(gg)
Financial, commercial, operations, and technical and research information and
data submitted to or obtained by the clean Washington center in applications
for, or delivery of, program services under chapter 70.95H RCW.
(hh)
Information and documents created specifically for, and collected and maintained
by a quality improvement committee pursuant to RCW 43.70.510, regardless of
which agency is in possession of the information and documents.
(2)
Except for information described in subsection (1)(c)(i) of this section and
confidential income data exempted from public inspection pursuant to RCW
84.40.020, the exemptions of this section are inapplicable to the extent that
information, the disclosure of which would violate personal privacy or vital
governmental interests, can be deleted from the specific records sought. No
exemption may be construed to permit the nondisclosure of statistical
information not descriptive of any readily identifiable person or persons.
(3)
Inspection or copying of any specific records exempt under the provisions of
this section may be permitted if the superior court in the county in which the
record is maintained finds, after a hearing with notice thereof to every person
in interest and the agency, that the exemption of such records is clearly
unnecessary to protect any individual's right of privacy or any vital
governmental function.
(4)
Agency responses refusing, in whole or in part, inspection of any public record
shall include a statement of the specific exemption authorizing the withholding
of the record (or part) and a brief explanation of how the exemption applies to
the record withheld.
Sec.
7. RCW
43.70.510 and 1993 c 492 s 417 are each amended to read as follows:
QUALITY
IMPROVEMENT PROGRAMS‑-ADDING CERTAIN STATE AGENCIES AND HEALTH CARRIERS.
(1)(a) Health care institutions and medical facilities, other than hospitals,
that are licensed by the department, professional societies or organizations,
((and certified)) health care service contractors, health maintenance
organizations, health ((plans)) carriers approved pursuant to
((RCW 43.72.100)) chapter 48.43 RCW, and any other person or entity
providing health care coverage under chapter 48.42 RCW that is subject to the
jurisdiction and regulation of any state agency or any subdivision thereof
may maintain a coordinated quality improvement program for the improvement of
the quality of health care services rendered to patients and the identification
and prevention of medical malpractice as set forth in RCW 70.41.200.
(b)
All such programs shall comply with the requirements of RCW 70.41.200(1)(a),
(c), (d), (e), (f), (g), and (h) as modified to reflect the structural
organization of the institution, facility, professional societies or
organizations, ((or certified)) health care service contractors,
health maintenance organizations, health ((plan)) carriers, or
any other person or entity providing health care coverage under chapter 48.42
RCW that is subject to the jurisdiction and regulation of any state agency or
any subdivision thereof, unless an alternative quality improvement program
substantially equivalent to RCW 70.41.200(1)(a) is developed. All such
programs, whether complying with the requirement set forth in RCW
70.41.200(1)(a) or in the form of an alternative program, must be approved by
the department before the discovery limitations provided in subsections (3) and
(4) of this section and the exemption under RCW 42.17.310(1)(hh) and
subsection (5) of this section shall apply. In reviewing plans submitted
by licensed entities that are associated with physicians' offices, the
department shall ensure that the exemption under RCW 42.17.310(1)(hh) and
the discovery limitations of this section are applied only to information and
documents related specifically to quality improvement activities undertaken by
the licensed entity.
(2)
Health care provider groups of ten or more providers may maintain a coordinated
quality improvement program for the improvement of the quality of health care
services rendered to patients and the identification and prevention of medical
malpractice as set forth in RCW 70.41.200. All such programs shall comply with
the requirements of RCW 70.41.200(1)(a), (c), (d), (e), (f), (g), and (h) as
modified to reflect the structural organization of the health care provider
group. All such programs must be approved by the department before the
discovery limitations provided in subsections (3) and (4) of this section and
the exemption under RCW 42.17.310(1)(hh) and subsection (5) of this section
shall apply.
(3) Any
person who, in substantial good faith, provides information to further the
purposes of the quality improvement and medical malpractice prevention program
or who, in substantial good faith, participates on the quality improvement
committee shall not be subject to an action for civil damages or other relief
as a result of such activity.
(4)
Information and documents, including complaints and incident reports, created
specifically for, and collected, and maintained by a quality improvement
committee are not subject to discovery or introduction into evidence in any
civil action, and no person who was in attendance at a meeting of such
committee or who participated in the creation, collection, or maintenance of
information or documents specifically for the committee shall be permitted or
required to testify in any civil action as to the content of such proceedings
or the documents and information prepared specifically for the committee. This
subsection does not preclude: (a) In any civil action, the discovery of the
identity of persons involved in the medical care that is the basis of the civil
action whose involvement was independent of any quality improvement activity;
(b) in any civil action, the testimony of any person concerning the facts that
form the basis for the institution of such proceedings of which the person had
personal knowledge acquired independently of such proceedings; (c) in any civil
action by a health care provider regarding the restriction or revocation of
that individual's clinical or staff privileges, introduction into evidence
information collected and maintained by quality improvement committees
regarding such health care provider; (d) in any civil action challenging the
termination of a contract by a state agency with any entity maintaining a
coordinated quality improvement program under this section if the termination
was on the basis of quality of care concerns, introduction into evidence of
information created, collected, or maintained by the quality improvement
committees of the subject entity, which may be under terms of a protective
order as specified by the court; (e) in any civil action, disclosure of the
fact that staff privileges were terminated or restricted, including the
specific restrictions imposed, if any and the reasons for the restrictions; or
(((e))) (f) in any civil action, discovery and introduction into
evidence of the patient's medical records required by rule of the department of
health to be made regarding the care and treatment received.
(5) Information
and documents created specifically for, and collected and maintained by a
quality improvement committee are exempt from disclosure under chapter 42.17
RCW.
(6)
The department of health shall adopt rules as are necessary to implement this
section.
Sec.
8. RCW
43.72.310 and 1993 c 492 s 448 are each amended to read as follows:
(1) Until
the effective date of this section and after June 30, 1996, a certified
health plan, health care facility, health care provider, or other person
involved in the development, delivery, or marketing of health care or certified
health plans may request, in writing, that the commission obtain an informal
opinion from the attorney general as to whether particular conduct is
authorized by chapter 492, Laws of 1993. Trade secret or proprietary
information contained in a request for informal opinion shall be identified as
such and shall not be disclosed other than to an authorized employee of the
commission or attorney general without the consent of the party making the
request, except that information in summary or aggregate form and market share
data may be contained in the informal opinion issued by the attorney general.
The attorney general shall issue such opinion within thirty days of receipt of
a written request for an opinion or within thirty days of receipt of any
additional information requested by the attorney general necessary for
rendering an opinion unless extended by the attorney general for good cause
shown. If the attorney general concludes that such conduct is not authorized
by chapter 492, Laws of 1993, the person or organization making the request may
petition the commission for review and approval of such conduct in accordance
with subsection (3) of this section.
(2)
After obtaining the written opinion of the attorney general and consistent with
such opinion, the health services commission:
(a)
May authorize conduct by a certified health plan, health care facility, health
care provider, or any other person that could tend to lessen competition in the
relevant market upon a strong showing that the conduct is likely to achieve the
policy goals of chapter 492, Laws of 1993 and a more competitive alternative is
impractical;
(b)
Shall adopt rules governing conduct among providers, health care facilities,
and certified health plans including rules governing provider and facility
contracts with certified health plans, rules governing the use of "most
favored nation" clauses and exclusive dealing clauses in such contracts,
and rules providing that certified health plans in rural areas contract with a
sufficient number and type of health care providers and facilities to ensure
consumer access to local health care services;
(c)
Shall adopt rules permitting health care providers within the service area of a
plan to collectively negotiate the terms and conditions of contracts with a certified
health plan including the ability of providers to meet and communicate for the
purposes of these negotiations; and
(d)
Shall adopt rules governing cooperative activities among health care facilities
and providers.
(3) Until
the effective date of this section and after June 30, 1996, a certified
health plan, health care facility, health care provider, or any other person
involved in the development, delivery, and marketing of health services or
certified health plans may file a written petition with the commission
requesting approval of conduct that could tend to lessen competition in the
relevant market. Such petition shall be filed in a form and manner prescribed
by rule of the commission.
The
commission shall issue a written decision approving or denying a petition filed
under this section within ninety days of receipt of a properly completed
written petition unless extended by the commission for good cause shown. The
decision shall set forth findings as to benefits and disadvantages and conclusions
as to whether the benefits outweigh the disadvantages.
(4) In
authorizing conduct and adopting rules of conduct under this section, the
commission with the advice of the attorney general, shall consider the benefits
of such conduct in furthering the goals of health care reform including but not
limited to:
(a)
Enhancement of the quality of health services to consumers;
(b)
Gains in cost efficiency of health services;
(c)
Improvements in utilization of health services and equipment;
(d)
Avoidance of duplication of health services resources; or
(e)
And as to (b) and (c) of this subsection: (i) Facilitates the exchange of
information relating to performance expectations; (ii) simplifies the
negotiation of delivery arrangements and relationships; and (iii) reduces the
transactions costs on the part of certified health plans and providers in
negotiating more cost-effective delivery arrangements.
These
benefits must outweigh disadvantages including and not limited to:
(i)
Reduced competition among certified health plans, health care providers, or
health care facilities;
(ii)
Adverse impact on quality, availability, or price of health care services to
consumers; or
(iii)
The availability of arrangements less restrictive to competition that achieve the
same benefits.
(5)
Conduct authorized by the commission shall be deemed taken pursuant to state
statute and in the furtherance of the public purposes of the state of
Washington.
(6)
With the assistance of the attorney general's office, the commission shall
actively supervise any conduct authorized under this section to determine
whether such conduct or rules permitting certain conduct should be continued
and whether a more competitive alternative is practical. The commission shall
periodically review petitioned conduct through, at least, annual progress
reports from petitioners, annual or more frequent reviews by the commission
that evaluate whether the conduct is consistent with the petition, and whether
the benefits continue to outweigh any disadvantages. If the commission
determines that the likely benefits of any conduct approved through rule,
petition, or otherwise by the commission no longer outweigh the disadvantages
attributable to potential reduction in competition, the commission shall order a
modification or discontinuance of such conduct. Conduct ordered discontinued
by the commission shall no longer be deemed to be taken pursuant to state
statute and in the furtherance of the public purposes of the state of
Washington.
(7)
Nothing contained in chapter 492, Laws of 1993 is intended to in any way limit
the ability of rural hospital districts to enter into cooperative agreements
and contracts pursuant to RCW 70.44.450 and chapter 39.34 RCW.
(8)
Only requests for informal opinions under subsection (1) of this section and
petitions under subsection (3) of this section that were received prior to the
effective date of this section or after June 30, 1996, shall be considered.
NEW
SECTION. Sec. 9. The
office of the attorney general shall study the impact on competition and
efficiency of antitrust immunities for health care providers and facilities in
Washington that exceed those provided under federal law and shall report to the
legislature by December 15, 1995. The study and report shall include a summary
of how other states have allowed for greater coordination and consolidation of
health care services without such additional immunities.
NEW
SECTION. Sec. 10. A new
section is added to chapter 43.72 RCW to read as follows:
(1)
Effective July 1, 1995, except as provided in subsection (2) of this section,
the duties of the health services commission under RCW 43.72.310 shall be
carried out by the health care policy board established in section 9, chapter
. . . (ESHB 1046), Laws of 1995.
(2)
For purposes of the transfer of duties under this section to the health care
policy board, legislative members are not appointed to the board and are not
members of the board.
Sec.
11. 1995 c
. . . (ESHB 1046) s 27 (uncodified) is amended to read as follows:
The
following acts or parts of acts are each repealed:
(1) RCW
18.130.320 and 1993 c 492 s 408;
(2) RCW
18.130.330 and 1994 c 102 s 1 & 1993 c 492 s 412;
(3) RCW
43.72.005 and 1993 c 492 s 401;
(4) RCW
43.72.010 and 1994 c 4 s 1, 1993 c 494 s 1, & 1993 c 492 s 402;
(5) RCW
43.72.020 and 1994 c 154 s 311 & 1993 c 492 s 403;
(6) RCW
43.72.030 and 1993 c 492 s 405;
(7) RCW
43.72.040 and 1994 c 4 s 3, 1993 c 494 s 2, & 1993 c 492 s 406;
(8) RCW
43.72.050 and 1993 c 492 s 407;
(9) RCW
43.72.060 and 1994 c 4 s 2 & 1993 c 492 s 404;
(10) RCW
43.72.070 and 1993 c 492 s 409;
(11) RCW
43.72.080 and 1993 c 492 s 425;
(12) RCW
43.72.090 and 1995 c 2 s 1 & 1993 c 492 s 427;
(13) RCW
43.72.100 and 1993 c 492 s 428;
(14) RCW
43.72.110 and 1993 c 492 s 429;
(15) RCW
43.72.120 and 1993 c 492 s 430;
(16) RCW
43.72.130 and 1993 c 492 s 449;
(17) RCW
43.72.140 and 1993 c 492 s 450;
(18) RCW
43.72.150 and 1993 c 492 s 451;
(19) RCW
43.72.160 and 1993 c 492 s 452;
(20) RCW
43.72.170 and 1995 c 2 s 2 & 1993 c 492 s 453;
(21) RCW
43.72.180 and 1993 c 492 s 454;
(22) RCW
43.72.190 and 1993 c 492 s 455;
(23) RCW
43.72.210 and 1993 c 492 s 463;
(24) RCW
43.72.220 and 1993 c 494 s 3 & 1993 c 492 s 464;
(25) RCW 43.72.225
and 1994 c 4 s 4;
(26) RCW
43.72.230 and 1993 c 492 s 465;
(27) RCW
43.72.240 and 1993 c 494 s 4 & 1993 c 492 s 466;
(28) ((RCW
43.72.300 and 1993 c 492 s 447;
(29) RCW
43.72.310 and 1993 c 492 s 448;
(30))) RCW
43.72.800 and 1993 c 492 s 457;
(((31))) (29)
RCW 43.72.810 and 1993 c 492 s 474;
(((32))) (30)
RCW 43.72.820 and 1993 c 492 s 475;
(((33))) (31)
RCW 43.72.830 and 1993 c 492 s 476;
(((34))) (32)
RCW 43.72.840 and 1993 c 492 s 478;
(((35))) (33)
RCW 43.72.870 and 1993 c 494 s 5;
(((36))) (34)
RCW 48.01.200 and 1993 c 492 s 294;
(((37))) (35)
RCW 48.43.010 and 1993 c 492 s 432;
(((38))) (36)
RCW 48.43.020 and 1993 c 492 s 433;
(((39))) (37)
RCW 48.43.030 and 1993 c 492 s 434;
(((40))) (38)
RCW 48.43.040 and 1993 c 492 s 435;
(((41))) (39)
RCW 48.43.050 and 1993 c 492 s 436;
(((42))) (40)
RCW 48.43.060 and 1993 c 492 s 437;
(((43))) (41)
RCW 48.43.070 and 1993 c 492 s 438;
(((44))) (42)
RCW 48.43.080 and 1993 c 492 s 439;
(((45))) (43)
RCW 48.43.090 and 1993 c 492 s 440;
(((46))) (44)
RCW 48.43.100 and 1993 c 492 s 441;
(((47))) (45)
RCW 48.43.110 and 1993 c 492 s 442;
(((48))) (46)
RCW 48.43.120 and 1993 c 492 s 443;
(((49))) (47)
RCW 48.43.130 and 1993 c 492 s 444;
(((50))) (48)
RCW 48.43.140 and 1993 c 492 s 445;
(((51))) (49)
RCW 48.43.150 and 1993 c 492 s 446;
(((52))) (50)
RCW 48.43.160 and 1993 c 492 s 426;
(((53))) (51)
RCW 48.43.170 and 1993 c 492 s 431;
(((54))) (52)
RCW 48.01.210 and 1993 c 462 s 51;
(((55))) (53)
RCW 48.20.540 and 1993 c 492 s 283;
(((56))) (54)
RCW 48.21.340 and 1993 c 492 s 284;
(((57))) (55)
RCW 48.44.480 and 1993 c 492 s 285;
(((58))) (56)
RCW 48.46.550 and 1993 c 492 s 286;
(((59))) (57)
RCW 70.170.100 and 1993 c 492 s 259, 1990 c 269 s 12, & 1989 1st ex.s. c 9
s 510;
(((60))) (58)
RCW 70.170.110 and 1993 c 492 s 260 & 1989 1st ex.s. c 9 s 511;
(((61))) (59)
RCW 70.170.120 and 1993 c 492 s 261;
(((62))) (60)
RCW 70.170.130 and 1993 c 492 s 262;
(((63))) (61)
RCW 70.170.140 and 1993 c 492 s 263;
(((64))) (62)
RCW 48.44.490 and 1993 c 492 s 288;
(((65))) (63)
RCW 48.46.560 and 1993 c 492 s 289; and
(((66))) (64)
RCW 43.72.200 and 1993 c 492 s 456.
NEW
SECTION. Sec. 12.
REPEALERS. The following acts or parts of acts are each repealed:
(1) RCW
70.170.100 and 1993 c 492 s 259, 1990 c 269 s 12, & 1989 1st ex.s. c 9 s
510;
(2) RCW
70.170.110 and 1993 c 492 s 260 & 1989 1st ex.s. c 9 s 511;
(3) RCW
70.170.120 and 1993 c 492 s 261;
(4) RCW
70.170.130 and 1993 c 492 s 262;
(5) RCW
70.170.140 and 1993 c 492 s 263; and
(6) RCW
43.72.070 and 1993 c 492 s 409.
NEW
SECTION. Sec. 13. RCW
70.170.080 and 1993 sp.s. c 24 s 925, 1991 sp.s. c 13 s 71, & 1989 1st
ex.s. c 9 s 508 are each repealed.
NEW
SECTION. Sec. 14. If
specific funding through the health services account to continue the
comprehensive hospital abstract reporting system is not provided by June 30,
1995, in the omnibus appropriations act, section 13 of this act is null and
void.
NEW
SECTION. Sec. 15.
CODIFICATION. Sections 1 through 4 of this act are each added to chapter 43.70
RCW.
NEW
SECTION. Sec. 16.
CAPTIONS. Captions as used in this act constitute no part of the law.
NEW
SECTION. Sec. 17.
SEVERABILITY. If any provision of this act or its application to any person or
circumstance is held invalid, the remainder of the act or the application of
the provision to other persons or circumstances is not affected.
NEW SECTION. Sec. 18. EMERGENCY
CLAUSE‑-EFFECTIVE DATE. This act is necessary for the immediate
preservation of the public peace, health, or safety, or support of the state
government and its existing public institutions, and shall take effect July 1,
1995, except sections 8 through 11 of this act which shall take effect
immediately.
