Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Ways & Means Committee

HB 1790

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Summary of Bill

Permits school districts to make direct practice agreements available to employees within the “basic benefits” package determined through collective bargaining agreements along with medical, dental, vision, life, and long-term disability insurance coverage.

Background:

Legislation passed in 2007 created a new chapter in Title 48 for direct patient-provider primary health care practices. The direct practices were explicitly exempted from the definition of health care service contractors in insurance law. Direct practices furnish primary care services in exchange for a direct fee from a patient. Services are limited to primary care including screening, assessment, diagnosis, and treatment for the purpose of promotion of health, and detection and management of disease or injury. Direct practices are also allowed to pay for charges associated with routine lab and imaging services. Direct practices are prevented from accepting payments for services provided to direct care patients from regulated insurance carriers, all insurance programs administered by the Health Care Authority, or self-insured plans. Direct practices may accept payment of direct fees directly or indirectly from non-employer third parties, but are prevented from selling their direct practice agreements directly to employer groups.

School districts and educational service districts may bargain with their employees over “basic benefits,” a limited group of benefits defined as including medical, dental, vision, group term life, and group long-term disability benefits. The benefits may be provided through contracts with private carriers, contract with the Washington State Health Care Authority, self-insurance, or other self-funded mechanism.

Summary of Bill:

Direct practice agreements are added to the definition of “basic benefits” for school and educational service district employees that may be determined through collective bargaining. School and educational service district boards are authorized to make direct practice agreements available to employees among the other employee benefits offered to employees through contracts with private carriers, the Health Care Authority, or through self-insurance or self-funding.