PERMANENT RULES
INSURANCE COMMISSIONER
Date of Adoption: March 5, 2003.
Purpose: The new rule implements RCW 48.43.023. This new regulation will also create consistent standards that will improve care to patients by minimizing confusion, eliminating unnecessary paperwork, decreasing administrative burdens, and streamlining dispensing of prescription products paid for by third-party payors.
Statutory Authority for Adoption: RCW 48.02.060, 48.43.023, 48.44.050, 48.46.200.
Adopted under notice filed as WSR 02-23-092 on November 20, 2002.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 1, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making:
New 0,
Amended 0,
Repealed 0;
Pilot Rule Making:
New 0,
Amended 0,
Repealed 0;
or Other Alternative Rule Making:
New 0,
Amended 0,
Repealed 0.
Effective Date of Rule:
Thirty-one days after filing.
March 5, 2003
Mike Kreidler
Insurance Commissioner
OTS-6058.2
SUBCHAPTER C
PROVIDER ((AND FACILITY)) CONTRACTS AND PAYMENT
NEW SECTION
WAC 284-43-323
Pharmacy identification cards.
(1) This
rule outlines the minimum standards for prescription claims
processing as directed by RCW 48.43.023.
(2) The pharmacy identification card or other technology must include the data element consistent with the "BIN number," "IIN/BIN number" or "RxBIN" which is the ANSI assigned international identification number, identified in the National Council for Prescription Drug Programs (NCPDP) Pharmacy ID Card Implementation Guide. Other data elements of the NCPDP Guide must be included on the card only if they are required for the processing of claims.
(3) This rule does not compel the issuance of a separate pharmacy identification card provided that the enrollee health plan identification card contains the required data elements.
(4) All plans that use a card or other technology for prescription claims processing that are delivered, issued for delivery or renewed on or after July 1, 2003, must comply with the requirements of this rule.
[]