BILL REQ. #:  H-0646.2 

Read first time 01/28/2005.   Referred to Committee on Health Care.

     AN ACT Relating to decreasing administrative burdens for providers and plans participating in state purchased health care programs; adding a new section to chapter 41.05 RCW; and making appropriations.

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

NEW SECTION.  Sec. 1   A new section is added to chapter 41.05 RCW to read as follows:
     To decrease administrative burdens for providers and plans participating in state purchased health care programs, the administrator, the assistant secretary for the medical assistance administration of the department of social and health services, and the director of the department of labor and industries, in collaboration with health carriers, health care providers, and the office of the insurance commissioner shall, within available resources:
     (1) Improve the timeliness of claims processing and the distribution of medical assistance program fee schedules, and more clearly define the scope of coverage under managed care contracts;
     (2) Improve the capacity for electronic billing and claims submission and provide electronic access to eligibility, benefits, and exclusion information;
     (3) Develop clear audit and data requirements for contracting managed health care plans and improve consistency between claims processing and published fee schedules;
     (4) Conform billing codes with providers and between agencies with national and regional standards wherever possible;
     (5) Take steps to implement cost-effective measures under this section by December 2006, and on or before December 1, 2005, provide a progress report to the relevant policy and fiscal committees of the legislature on the feasibility of implementation and any fiscal constraints or regulatory or statutory barriers; and
     (6) Participate in a standardized, secure on-line health care information exchange program.

NEW SECTION.  Sec. 2   (1) The sum of one hundred thousand dollars, or as much thereof as may be necessary, is appropriated for the fiscal year ending June 30, 2006, from the general fund to the department of social and health services to participate in a standardized, secure on-line health care information exchange program.
     (2) The sum of one hundred thousand dollars, or as much thereof as may be necessary, is appropriated for the fiscal year ending June 30, 2007, from the general fund to the department of social and health services to participate in a standardized, secure on-line health care information exchange program.