SHB 2943 -
By Representative Cody
Strike everything after the enacting clause and insert the following:
"NEW SECTION. Sec. 1 A new section is added to chapter 48.43 RCW
to read as follows:
(1) Every health carrier, insurer, and other organization engaged
in the business of creating provider networks shall comply with the
provisions of this section in selecting and contracting with health
care providers. For the purpose of this section, "contractor" refers
to health carriers, insurers, and other organizations engaged in the
business of creating provider networks.
(2) Contractors may not discriminate against various classes of
health care practitioners by adopting health care network selection and
credentialing standards that permit selection and credentialing of
clinics of only one or certain classes of practitioners. For example
and not as a limitation of this subsection, if a contractor permits a
clinic comprising physicians and nurses to contract on a clinic rather
than upon an individual basis, the contractor must permit a clinic
comprising chiropractors and licensed massage therapists to contract on
a clinic rather than upon an individual basis.
(3) Contractors may not refuse to contract with a provider or
providers who purchase the practice of an existing contracted provider
if the purchasing provider or providers otherwise meet the
credentialing standards of the contractor and agree to comply with the
terms and conditions of the provider contract, including provisions
related to quality assurance and utilization review.
(4) Contractors may not refuse to contract with a provider who
works as an employee of a contracted provider if the employee otherwise
meets the credentialing standards of the contractor and agrees to
comply with the terms and conditions of the provider contract,
including provisions related to quality assurance and utilization
review.
(5) A contractor may not directly or indirectly require a health
care provider to participate in any arrangement that is not a health
plan as a condition for participating in any of the contractor's health
plans.
(6) For purposes of this section, "health plan" includes a health
plan as defined in RCW 48.43.005 and medical coverage programs
administered by the health care authority.
NEW SECTION. Sec. 2 The insurance commissioner may adopt rules
necessary to implement this act."