WSR 26-15-122
PREPROPOSAL STATEMENT OF INQUIRY
OFFICE OF THE
INSURANCE COMMISSIONER
[Insurance Commissioner Matter R 2026-02—Filed July 21, 2026, 5:11 p.m.]
Subject of Possible Rule Making: Consolidated health care rule: Rule making is needed to address changes in state law and update existing rules to ensure a well-functioning health insurance market.
The subjects of the possible rule making include, but are not limited to:
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| • | Implementation of ESHB 2242 (2026): Updating existing rules that reference the United States Preventive Services Task Force, Health Resources and Services Administration, and the Advisory Committee on Immunization Practices. Rule making is also needed to reflect current and additional future preventive care and screening guidelines, including immunization recommendations made by the Washington state department of health (DOH); |
| • | ESHB 1187 (2026): Establishing an opportunity to cure and a DOH referral process for ground ambulances that fail to comply with the new requirements in the bill; |
| • | E2SSB 5395 (2026): Amending the prior authorization regulations related to determination notifications and the use of artificial intelligence for private health insurance and health plans offered to public or school employees; |
| • | ESSB 5845 (2026): Implementing new health carrier clean claim payment or claim denial requirements; and |
| • | Balance Billing Protection Act (BBPA) rules: Updating various WAC sections to strengthen the arbitration process and clarify the training requirements and responsibilities of arbitrators, including ethics and proper document handling. |
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The office of the insurance commissioner (OIC) is considering consolidated health care rule making due to the recent passage of insurance-related legislation and other changes in the state health insurance market including, but not limited to, impacts within the BBPA arbitration process. Multiple provisions of health care and insurance regulations in WAC may need to be updated to be consistent with the legislation passed and codified in RCW and other recent state or federal law changes.
These rules will facilitate implementation of the new laws by ensuring that all affected entities understand their legal rights and obligations under the enacted legislation and law changes.
This rule making may include, but is not limited to, WAC 284-43-5642, 284-43-5644, 284-170-431, 284-170-130, 284-51-215, 284-43-2050; chapter 284-43 WAC, subchapters D and E; 284-43B-035, and 284-43B-037.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: OIC is promulgating administrative rules related to the commercial plans it regulates. However, there are other state agencies that may be affected by this rule making.
DOH is responsible for making immunization recommendations that OIC will need to codify in a rule. Therefore, OIC will coordinate the rule making with other agencies, including DOH, by offering notices and opportunities for written comment or feedback with multiple participation forums. DOH is also responsible for the enforcement mechanism, should a ground ambulance fail to comply with the laws regarding delayed ambulance bills. OIC will coordinate the rule making with other agencies, including DOH, by offering notices and opportunities for written comment or feedback with multiple participation forums.
The health care authority (HCA) has similar statutory authority to OIC over the public employees benefits board/state employees benefits board health plans and managed care organizations plans they regulate. OIC will coordinate this rule making with other agencies, including HCA, by offering notices and opportunities for written comment or feedback with multiple participation forums.
Process for Developing New Rule: The public comment period began at 8:00 a.m. on July 22, 2026, and will close at 11:59 p.m. on August 5, 2026.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Rules Coordinator, 302 Sid Snyder Avenue S.W., Olympia, WA 98504, phone 360-725-7171, fax 360-586-3109, TTY 360-586-0241, email rulescoordinator@oic.wa.gov, website www.insurance.wa.gov.
July 21, 2026
Patty Kuderer
Insurance Commissioner