6228-S AMS MULL NEED 035

SSB 6228 - S AMD 428

By Senators Mullet, Becker

ADOPTED 02/14/2014

    On page 2, line 14 after "(b)" insert the following "Recognizing integrated health care delivery systems focus on total cost of care, carrier's operating integrated care delivery systems may meet the requirement of subsection (a) by providing meaningful consumer data based on the total cost of care.  This subsection applies only to the portion of enrollment a carrier offers pursuant to Chapter 48.46 RCW and as part of an integrated delivery system, and does not exempt from subsection (a) coverage offered pursuant to Chapter 48.21, 48.44, or 48.46 RCW if not part of an integrated delivery system;"

    Correct the internal references accordingly.

    On page 2, line 19 after "review" insert the following ", the feedback must be monitored for appropriateness and validity, and the site may include independently compiled quality of care ratings of providers and facilities"

    On page 2, line 21 after "treatment" insert the following ", or the total cost of care," and on line 21, after "(a)" insert "and (b)"

    On page 2, line 25 after "treatment" insert the following ", or total cost of the care episode,"

    On page 2, line 33 after "available" insert the following "or medical versus surgical alternatives as appropriate"

    On page 3, on line 9 after "site." Insert the following "(4) The commissioner may not expand the requirements of this act by rule."

EFFECT:

· Adds references to integrated health care delivery systems and their display of the total cost of care or the cost of care per episode, and links the integrated delivery systems to the statute for Health Maintenance Organizations.

· Adds to the patient review option to ensure the feedback is monitored for appropriateness and validity, and that the site may include independent quality of care ratings

· Adds to the additional alternatives that may be cost effective, with medical vs surgical alternatives

· Adds that the commissioner may not expand the requirements of this act by rule.

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