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.
