6404-S.E AMH DEBO WEIK 190

ESSB 6404 - H AMD TO HCW COMM AMD (6404-S.E AMH HCW WEIK 172) 2058

By Representative DeBolt

ADOPTED 03/05/2020

On page 1, line 5 of the striking amendment, after "By" strike "October 1, 2020" and insert "April 1, 2021"

On page 3, line 10 of the striking amendment, after "(e)" insert "Lists of the ten diabetes supplies and equipment codes: (i) With the highest total number of prior authorization requests during the previous plan year, including the total number of prior authorization requests for each code and the percent of approved requests for each code; (ii) With the highest percentage of approved prior authorization requests during the previous plan year, including the total number of prior authorization requests for each code and the percent of approved requests for each code; (iii) With the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal, including the total number of prior authorization requests for each code and the percent of requests that were initially denied and then subsequently approved for each code;

(f)"

On page 3, line 12 of the striking amendment, after "through" strike "(d)" and insert "(e)"

On page 3, line 17 of the striking amendment, after "By" strike "January" and insert "July"

EFFECT: Requires carriers to submit to the Insurance Commissioner the ten diabetes supplies and equipment codes for the previous plan year that had the highest number of total authorization requests, had the highest prior authorization approval percentage, and had the highest number of prior authorization requests that were initially denied and subsequently approved, and the average response times for each code. Delays the date a carrier must provide data to the Commissioner and the date the Commissioner must collect the data into a standard report six months.

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