FINAL BILL REPORT

SHB 1183

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.

C 166 L 15

Synopsis as Enacted

Brief Description: Concerning radiology benefit managers.

Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Harris and Cody).

House Committee on Health Care & Wellness

Senate Committee on Health Care

Background:

Radiology uses medical imaging technology to diagnose and treat disease. There are two primary categories of radiology: diagnostic radiology and interventional radiology. Diagnostic radiology uses medical imaging technology to diagnose a patient's symptoms, monitor responses to treatment, and to screen for illnesses. Interventional radiology uses medical imaging technology to guide procedures to treat conditions such as cancer, blockages in arteries and veins, liver problems, and kidney problems. Types of medical imaging technologies include computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, nuclear medicine, and x-rays.

Radiology benefit managers generally perform management activities related to benefits for imaging services on behalf of health carriers. These may include developing guidelines on the use of radiology services, conducting prior authorization activities, privileging certain providers to order radiology services, and profiling a provider's use of services to confirm that they meet certain benchmarks.

Summary:

Each radiology benefit manager that is owned by a health carrier or acts as a subcontractor to a health carrier must register with the Department of Revenue's Business Licensing Program. To register, a radiology benefit manager must submit an application with identifying information and a registration fee of $200. Radiology benefit managers must renew their registrations annually.

"Radiology benefit managers" are persons who contract with, or are owned by, insurers or third-party payors to provide services to: (1) process claims for services and procedures performed by radiologists or advanced diagnostic imaging services providers; or (2) pay or authorize payments to radiology clinics, radiologists, or advanced diagnostic imaging services providers for services or procedures.

Votes on Final Passage:

House

88

10

Senate

44

4

(Senate amended)

House

87

9

(House concurred)

Effective:

July 24, 2015