Revised Code of Washington
2023 Archive

Chapter 41.05 RCW
STATE HEALTH CARE AUTHORITY
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PDF of Complete Chapter
Sections
41.05.004Intent—Use of word "board."
41.05.006Purpose.
41.05.008Duties of employing agencies.
41.05.009Determination of public employee eligibility for benefits.
41.05.0091Eligibility exists prior to January 1, 2010.
41.05.011Definitions.
41.05.013State purchased health care programs—Uniform policies.
41.05.014Applications, enrollment forms, and eligibility certification documents—Signatures.
41.05.015Medical director—Appointment of personnel.
41.05.017Provisions applicable to health plans offered under this chapter.
41.05.018Transfer of certain behavioral health-related powers, duties, and functions from the department of social and health services.
41.05.021State health care authority—Director—Cost control and delivery strategies—Health information technology—Managed competition—Rules.
41.05.022State agent for purchasing health services—Single community-rated risk pool.
41.05.023Chronic care management program—Uniform medical plan—Definitions.
41.05.026Contracts—Proprietary data, trade secrets, actuarial formulas, statistics, cost and utilization data—Exemption from public inspection—Executive sessions.
41.05.031Health information technology office—Agencies to establish health care information systems.
41.05.035Exchange of health information—Advisory board, discretionary—Director's authority.
41.05.036Health information—Definitions.
41.05.037Nurse hotline, when funded.
41.05.039Health information—Secure access—Lead organization—Director's duties.
41.05.042Health information—Processes, guidelines, and standards.
41.05.046Health information—Conflict with federal requirements.
41.05.050Contributions for employees and dependents.
41.05.055Public employees' benefits board—Members.
41.05.065Public employees' benefits board—Duties—Eligibility—Definitions—Penalties.
41.05.066Domestic partner benefits.
41.05.068Federal employer incentive program—Authority to participate.
41.05.074Public employees—Prior authorization standards and criteria—Health plan requirements—Definitions.
41.05.075Employee benefit plans—Contracts with insuring entities—Performance measures—Financial incentives—Health information technology.
41.05.080Participation in insurance plans and contracts—Retired, disabled, or separated employees—Certain surviving spouses, state registered domestic partners, and dependent children.
41.05.083Employer groups—Participation in insurance plans and contracts—Termination of agreement—Payment for retired or disabled employees.
41.05.085Retired state employee and retired or disabled school employee health insurance subsidy.
41.05.095Coverage for dependents under the age of twenty-six.
41.05.100Chapter not applicable to certain employees of Cooperative Extension Service.
41.05.120Public employees' and retirees' insurance account—School employees' insurance account.
41.05.123Flexible spending administrative account—Salary reduction account—School employees' benefits board flexible spending and dependent care administrative account—School employees' benefits board salary reduction account.
41.05.130State health care authority administrative account—School employees' insurance administrative account.
41.05.140Payment of claims—Self-insurance—Insurance reserve fund created.
41.05.143Uniform medical plan benefits administration account—Uniform dental plan benefits administration account—School employees' benefits board medical benefits administrative account—School employees' benefits board dental benefits administration account.
41.05.160Rules.
41.05.165Rules—Insurance benefit reimbursement.
41.05.170Neurodevelopmental therapies—Employer-sponsored group contracts.
41.05.175Prescribed, self-administered anticancer medication.
41.05.177Prostate cancer screening—Required coverage.
41.05.180Mammograms—Insurance coverage.
41.05.183General anesthesia services for dental procedures—Public employee benefit plans.
41.05.185Diabetes benefits—State purchased health care.
41.05.188Eosinophilic gastrointestinal associated disorder—Elemental formula.
41.05.195Medicare supplemental insurance policies.
41.05.197Medicare supplemental insurance policies.
41.05.220Community and migrant health centers—Maternity health care centers—People of color—Underserved populations.
41.05.225Blind licensees in the business enterprises program—Plan of health insurance.
41.05.295Dependent care assistance program—Health care authority—Powers, duties, and functions.
41.05.300Salary reduction agreements—Authorized.
41.05.310Salary reduction plan—Policies and procedures—Plan document.
41.05.320Salary reduction plan—Eligibility—Participation, withdrawal.
41.05.330Salary reduction plan—Accounts and records.
41.05.340Salary reduction plan—Termination—Amendment.
41.05.350Salary reduction plan—Rules.
41.05.360Salary reduction plan—Construction.
41.05.400Plan of health care coverage—Available funds—Components—Eligibility—Director's duties.
41.05.405Public option plans—Availability—Hospital contracts—Recommendations.
41.05.410Qualified health plans—Contract for—Requirements—Cost and quality data.
41.05.413Qualified health plans—Reimbursement limit—Waiver.
41.05.430Plan of health care coverage—Immediate postpartum contraception devices.
41.05.520Pharmacy connection program—Notice.
41.05.525Treatment of opioid use disorder—Prior authorization.
41.05.526Withdrawal management services—Substance use disorder treatment services—Prior authorization—Utilization review—Medical necessity review.
41.05.527Opioid overdose reversal medication bulk purchasing and distribution program.
41.05.528Standard set of criteria—Medical necessity for substance use disorder treatment—Substance use disorder levels of care—Rules.
41.05.530Prescription drug assistance, education—Rules.
41.05.533Medication synchronization policy required for health benefit plans covering prescription drugs—Requirements—Definitions.
41.05.540State employee health program—Requirements.
41.05.550Prescription drug assistance foundation—Nonprofit and tax-exempt corporation—Definitions—Liability.
41.05.600Mental health services—Definition—Coverage required, when.
41.05.601Mental health services—Rules.
41.05.630Annual report of customer service complaints and appeals.
41.05.650Community health care collaborative grant program—Grants—Administrative support—Eligibility.
41.05.651Rules—2009 c 299.
41.05.660Community health care collaborative grant program—Award and disbursement of grants.
41.05.670Chronic care management incentives—Provider reimbursement methods.
41.05.690Performance measures committee—Membership—Selection of performance measures—Benchmarks for purchasing decisions—Public process for evaluation of measures.
41.05.700Reimbursement of health care services provided through telemedicine or store and forward technology—Audio-only telemedicine.
41.05.730Ground emergency medical transportation services—Medicaid reimbursement—Calculation—Federal approval—Department's duties.
41.05.735Ground emergency medical transportation services—Medicaid reimbursement—Intergovernmental transfer program—Federal approval—Authority's duties.
41.05.740School employees' benefits board.
41.05.742Single enrollment requirement.
41.05.743School board members—Eligibility for health benefits.
41.05.744School employee eligibility during COVID-19 state of emergency.
41.05.745School employees' benefits board—Employee-paid, voluntary benefits—Optional benefits.
41.05.750Problem gambling and gambling disorder treatment program.
41.05.751Problem gambling account.
41.05.760Recovery residences—Registry.
41.05.761Recovery residences—Technical assistance for residences seeking certification.
41.05.762Recovery residences—Revolving fund.
41.05.810Prenatal substance exposure treatment—Contracting.
41.05.820Qualified requirement for health carrier in insurance holding company to offer silver and gold health plans.
41.05.830Coverage for hearing instruments—Definitions.
41.05.831Coverage for hearing instruments.
41.05.840Universal health care commission.
41.05.845Prior authorization.
41.05.850Abortion coverage—Cost sharing.
41.05.890Certain health care and financial related data provided to authority—Exempt from disclosure.
41.05.900Short title.
41.05.901Implementation—Effective dates—1988 c 107.
41.05.950Retired or disabled public employees—Special health coverage enrollment opportunity.
41.05.951Retired or disabled employees of employer groups—Return following termination of employer's agreement—2023 c 312.
NOTES:
Hospitalization and health care for county, municipal and other political subdivision employees: RCW 41.04.180.
Monitoring enrollee level in basic health plan and medicaid caseload of children—Funding levels adjustment: RCW 43.41.260.
Prepaid chiropractic, pilot projects: RCW 18.25.200.