READ FIRST TIME 02/03/06.   

     AN ACT Relating to health care provider contracting; adding a new section to chapter 48.43 RCW; and creating a new section.

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

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.