Revised Code of Washington
2024 Archive

Chapter 41.05 RCW
STATE HEALTH CARE AUTHORITY
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PDF of Complete Chapter
Sections
41.05.004IntentUse 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 programsUniform policies.
41.05.014Applications, enrollment forms, and eligibility certification documentsSignatures.
41.05.015Medical directorAppointment 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 authorityDirectorCost control and delivery strategiesHealth information technologyManaged competitionRules.
41.05.022State agent for purchasing health servicesSingle community-rated risk pool.
41.05.023Chronic care management programUniform medical planDefinitions.
41.05.026ContractsProprietary data, trade secrets, actuarial formulas, statistics, cost and utilization dataExemption from public inspectionExecutive sessions.
41.05.031Health information technology officeAgencies to establish health care information systems.
41.05.035Exchange of health informationAdvisory board, discretionaryDirector's authority.
41.05.036Health informationDefinitions.
41.05.037Nurse hotline, when funded.
41.05.039Health informationSecure accessLead organizationDirector's duties.
41.05.042Health informationProcesses, guidelines, and standards.
41.05.046Health informationConflict with federal requirements.
41.05.050Contributions for employees and dependents.
41.05.055Public employees' benefits boardMembers.
41.05.065Public employees' benefits boardDutiesEligibilityDefinitionsPenalties.
41.05.066Domestic partner benefits.
41.05.068Federal employer incentive programAuthority to participate.
41.05.074Public employeesPrior authorization standards and criteriaHealth plan requirementsDefinitions.
41.05.075Employee benefit plansContracts with insuring entitiesPerformance measuresFinancial incentivesHealth information technology.
41.05.080Participation in insurance plans and contractsRetired, disabled, or separated employeesCertain surviving spouses, state registered domestic partners, and dependent children.
41.05.083Employer groupsParticipation in insurance plans and contractsTermination of agreementPayment 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 accountSchool employees' insurance account.
41.05.123Flexible spending administrative accountSalary reduction accountSchool employees' benefits board flexible spending and dependent care administrative accountSchool employees' benefits board salary reduction account.
41.05.130State health care authority administrative accountSchool employees' insurance administrative account.
41.05.140Payment of claimsSelf-insuranceInsurance reserve fund created.
41.05.143Uniform medical plan benefits administration accountUniform dental plan benefits administration accountSchool employees' benefits board medical benefits administrative accountSchool employees' benefits board dental benefits administration account.
41.05.155Fern Lodge maintenance account.
41.05.160Rules.
41.05.165RulesInsurance benefit reimbursement.
41.05.170Neurodevelopmental therapiesEmployer-sponsored group contracts.
41.05.175Prescribed, self-administered anticancer medication.
41.05.177Prostate cancer screeningRequired coverage.
41.05.180MammogramsInsurance coverage.
41.05.183General anesthesia services for dental proceduresPublic employee benefit plans.
41.05.185Diabetes benefitsState purchased health care.
41.05.188Eosinophilic gastrointestinal associated disorderElemental formula.
41.05.195Medicare supplemental insurance policies.
41.05.197Medicare supplemental insurance policies.
41.05.220Community and migrant health centersMaternity health care centersPeople of colorUnderserved populations.
41.05.225Blind licensees in the business enterprises programPlan of health insurance.
41.05.295Dependent care assistance programHealth care authorityPowers, duties, and functions.
41.05.300Salary reduction agreementsAuthorized.
41.05.310Salary reduction planPolicies and proceduresPlan document.
41.05.320Salary reduction planEligibilityParticipation, withdrawal.
41.05.330Salary reduction planAccounts and records.
41.05.340Salary reduction planTerminationAmendment.
41.05.350Salary reduction planRules.
41.05.360Salary reduction planConstruction.
41.05.400Plan of health care coverageAvailable fundsComponentsEligibilityDirector's duties.
41.05.405Public option plansAvailabilityHospital contractsRecommendations.
41.05.410Qualified health plansContract forRequirementsCost and quality data.
41.05.413Qualified health plansReimbursement limitWaiver.
41.05.430Plan of health care coverageImmediate postpartum contraception devices.
41.05.520Pharmacy connection programNotice.
41.05.525Treatment of opioid use disorderPrior authorization.
41.05.526Withdrawal management servicesSubstance use disorder treatment servicesPrior authorizationUtilization reviewMedical necessity review.
41.05.527Opioid overdose reversal medication bulk purchasing and distribution program.
41.05.528Standard set of criteriaMedical necessity for substance use disorder treatmentSubstance use disorder levels of careRules.
41.05.530Prescription drug assistance, educationRules.
41.05.531Standard set of criteriaUpdated versionsReview and use.
41.05.533Medication synchronization policy required for health benefit plans covering prescription drugsRequirementsDefinitions.
41.05.540State employee health programRequirements.
41.05.550Prescription drug assistance foundationNonprofit and tax-exempt corporationDefinitionsLiability.
41.05.600Mental health servicesDefinitionCoverage required, when.
41.05.601Mental health servicesRules.
41.05.630Annual report of customer service complaints and appeals.
41.05.650Community health care collaborative grant programGrantsAdministrative supportEligibility.
41.05.651Rules2009 c 299.
41.05.660Community health care collaborative grant programAward and disbursement of grants.
41.05.670Chronic care management incentivesProvider reimbursement methods.
41.05.690Performance measures committeeMembershipSelection of performance measuresBenchmarks for purchasing decisionsPublic process for evaluation of measures.
41.05.700Reimbursement of health care services provided through telemedicine or store and forward technologyAudio-only telemedicine.
41.05.730Ground emergency medical transportation servicesMedicaid reimbursementCalculationFederal approvalDepartment's duties.
41.05.735Ground emergency medical transportation servicesMedicaid reimbursementIntergovernmental transfer programFederal approvalAuthority's duties.
41.05.740School employees' benefits board.
41.05.742Single enrollment requirement.
41.05.743School board membersEligibility for health benefits.
41.05.744School employee eligibility during COVID-19 state of emergency.
41.05.745School employees' benefits boardEmployee-paid, voluntary benefitsOptional benefits.
41.05.750Problem gambling and gambling disorder treatment program.
41.05.751Problem gambling account.
41.05.760Recovery residencesRegistry.
41.05.761Recovery residencesTechnical assistance for residences seeking certification.
41.05.762Recovery residencesRevolving fund.
41.05.810Prenatal substance exposure treatmentContracting.
41.05.812Prenatal substance exposureExpanded treatment and services.
41.05.820Qualified requirement for health carrier in insurance holding company to offer silver and gold health plans.
41.05.831Coverage for hearing instruments.
41.05.840Universal health care commission.
41.05.845Prior authorization.
41.05.850Abortion coverageCost sharing.
41.05.890Certain health care and financial related data provided to authorityExempt from disclosure.
41.05.900Short title.
41.05.901ImplementationEffective dates1988 c 107.
41.05.950Retired or disabled public employeesSpecial health coverage enrollment opportunity.
41.05.951Retired or disabled employees of employer groupsReturn following termination of employer's agreement2023 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 childrenFunding levels adjustment: RCW 43.41.260.
Prepaid chiropractic, pilot projects: RCW 18.25.200.