WSR 16-24-060
[Filed December 5, 2016, 8:22 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 16-21-052.
Title of Rule and Other Identifying Information: WAC 82-75-060 Historical data submission.
Hearing Location(s): Office of Financial Management (OFM), Insurance Building, 302 Sid Snyder Avenue S.W., Conference Room 440, Olympia, WA 98501, on January 10, 2017, at 10:00 a.m.
Date of Intended Adoption: February 7, 2017.
Submit Written Comments to: Mandy Stahre, OFM, P.O. Box 43113, Olympia, WA 98504-3113, e-mail, fax (360) 725-5517, comments must be submitted by January 10, 2017.
Assistance for Persons with Disabilities: Contact OFM by January 6, 2017, TTY (360) 753-4107 or (360) 902-3092.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of this rule-making proposal relates to the statewide all-payer health care claims data base (APCD). Specifically, the rule amendment will change the time period in the definition of "historical data." The rule currently defines historical data as data for the period of January 1, 2011, through December 31, 2015. The end date is being change[d] to "April 1, 2017 or from the start date of the first regular quarterly submission in accordance with the data submission schedule."
Reasons Supporting Proposal: Originally, WAC 82-75-060 defined "historical data" as data files for the period of January 1, 2011, through December 31, 2015. This period was developed based on the time period in which it was anticipated that APCD would be implemented. Due to the delay in implementation, it is necessary to put in place a different and more flexible historical data time period.
Statutory Authority for Adoption: Chapter 43.371 RCW.
Statute Being Implemented: Chapter 43.371 RCW.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: OFM, governmental.
Name of Agency Personnel Responsible for Drafting: Roselyn Marcus, 302 Sid Snyder Avenue S.W., Olympia, WA 98501, (360) 902-0434; Implementation and Enforcement: Thea Mounts, General Administration Building, Olympia, WA 98501, (360) 902-0552.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The rules do not have an impact to small businesses, as that term is defined in statute.
A cost-benefit analysis is not required under RCW 34.05.328. These rules are not significant legislative rules, as defined in statute. These rules are not subject to this requirement.
December 5, 2016
Roselyn Marcus
Assistant Director of
Legal and Legislative Affairs
AMENDATORY SECTION (Amending WSR 16-04-068, filed 1/29/16, effective 2/29/16)
WAC 82-75-060 Historical data submission.
(1) The purpose of collecting historical data into the WA-APCD is to permit the systematic analysis of the health care delivery system including evaluation of the effectiveness of the Patient Protection and Affordable Care Act signed into law on March 23, 2010.
(2) The lead organization will provide written notification to the data suppliers when the WA-APCD is ready to accept the submission of historical data. Data suppliers shall submit the historical data within sixty days of notification. Requests for an extension of time to submit historical data shall be made in accordance with WAC 82-75-080(3).
(3) "Historical data" means covered medical services claim files, pharmacy claim files, dental claim files, member eligibility and enrollment data files, and provider data files with necessary identifiers for the period January 1, ((2011)) 2013, through December 31, ((2015)) 2016, or through the end of the quarter immediately prior to the first regular quarterly submission due in accordance with the data submission schedule.
(4) The office may grant an exception to this section and approve the filing of historical data for a period less than the period specified in subsection (3) of this section. ((In no event will an exception be granted for a period beginning later than January 1, 2013.)) Requests for an exception under this subsection shall be made to the lead organization within fifteen calendar days of being notified in accordance with subsection (2) of this section. The lead organization shall make a recommendation to the office as to whether to approve or deny the request. The office may approve the request for good cause.