H-0446.1  _______________________________________________

                          HOUSE BILL 1167

          _______________________________________________

State of Washington      55th Legislature     1997 Regular Session

By Representatives Dyer, Cody, Backlund, Sheahan, Cooke, Sherstad, Huff, Schoesler, L. Thomas, Radcliff, Cairnes, Pennington, Ballasiotes, Chandler, Skinner, Hankins, Parlette, Alexander, Koster, Lisk, Carlson, Clements, Zellinsky, Murray, H. Sommers, Conway, Honeyford, Dunn, Mielke, Mason and Thompson

Read first time 01/17/97.  Referred to Committee on Health Care.

Limiting health care providers' liability when third party payors refuse to pay for health care services.

    AN ACT Relating to limiting health care providers' liability when third parties refuse to pay for health care services; and adding a new section to chapter 7.70 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.  A new section is added to chapter 7.70 RCW to read as follows:

    A health care provider, as defined in RCW 48.43.005, is not liable for the decision of a third-party payer or others not to pay for or provide reimbursement for health care services recommended by the health care provider when:

    (1) The health care provider complies with any formal or informal avenues of appeal made available by the third-party payer or others under a health plan, as defined in RCW 48.43.005, or under any other contract or policy providing or paying for health care benefits or services; and

    (2) The health care provider advises the patient to obtain the recommended care, even if not covered by the third-party payer, and informs the patient of the potential risks in not obtaining the recommended health care services.

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