Title: An act relating to evidence-based health services purchasing by state purchased health care programs.

Brief Description: Providing for evidence-based health services purchasing by state purchased health care programs.

Brief Summary of Substitute Bill

• Requires uniform policies across all state purchased health care programs in five separate Executive branch agencies.

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 8 members: Representatives Cody, Chair; Morrell, Vice Chair; Campbell, Clibborn, Darneille, Edwards, Moeller and Schual-Berke.

Minority Report: Without recommendation. Signed by 5 members: Representatives Pflug, Ranking Minority Member; Bailey, Assistant Ranking Minority Member; Alexander, Benson and Skinner.

The Health Care Authority (Authority) is responsible for studying all state-purchased health care, alternative health care delivery systems, and strategies for the procurement of health care services, and making recommendations aimed at minimizing the financial burden which health care poses on the state. The Authority is also expected to implement state initiatives, joint purchasing strategies, cost-control strategies, and techniques for efficient administration that have potential application to all state-purchased health services.

The Health Care Authority is required to coordinate the development and implementation of uniform policies across all state-purchased health care programs related to purchasing, administrative efficiencies, improving quality of care, and reducing administrative burdens on participating health care providers. The policies will require uniform means of assessing health care services, monitoring several aspects of health services, developing common definitions of medical necessity, and common disease and demand management strategies. The policies will be consistent with the policies developed relating to prescription drugs developed under separate legislation.

The Secretaries of Health, Social and Health Services, Corrections, and the Director of Labor and Industries are required to cooperate, to the maximum extent possible, in developing and implementing the policies.

Experimental or investigational treatments or services will not be precluded by the adopted policies. The adopted policies will be consistent with the multi-agency preferred drug list. Participating agencies are required to cooperatively adopt rules.

Effective Date of Substitute Bill: The bill takes effect ninety days after adjournment of session in which bill is passed.

Testimony For: Greater efficiency and effectiveness will be achieved if agencies purchasing health care adopt uniform policies.

Testimony Against: There should be a process for individuals or parties who disagree with those policies to challenge them.

Testified: (In support) Dennis Martin, Health Care Authority; Gary Franklin, Department of Labor & Industries; and Roger Gantz, Department of Social and Health Services Medical Assistance Administration.

(Concerns) Andy Dolan, Washington State Medical Association; and Jackie Der, University of Washington.