WSR 06-15-047

AGENDA

HEALTH CARE AUTHORITY


[ Filed July 11, 2006, 8:43 a.m. ]


July 31, 2006 Semi-annual Rule-Making Agenda


Approximate Preproposal

1. Date

2. Subject Area

3. Contact/Telephone Number

Purpose of the Rule

Why Is this Significant?

Rule(s) Mandate Other Agencies Who May Have Interest in the Subject of Rule(s)
1. CR-101

2. September 2006

3. Rebecca Burch, (360) 923-2712

In the 2006 legislative session, the legislature created the small employer health insurance partnership program (the partnership). The partnership is intended to assist employees of small businesses (those with fifty or fewer employees) in participating in their employer's small group health plan. The partnership will issue a subsidy toward the eligible employee's share of the health insurance premium.

Rules must be created to support the intent of the program. Issues to be addressed include, but are not limited to:

Definitions.

Eligibility.

Enrollment.

Issuance of subsidies.

Recertification.

Disenrollment.

Subsidy overpayments.

Appeals.

As a part of the rule-making process, HCA will consult with various stakeholders, including small employers, carriers, and employee organizations, OIC and DSHS.

Chapter 255, Laws of 2006 (E2SHB 2752). The office of the insurance commissioner.

The department of social and health services.

1. July 2006 (expedited filing)

2. Chapter 182-12 WAC

3. Barbara Scott, (360) 923-2642

The 2006 legislature passed SB 6723 which expanded PEBB eligibility to include "surviving spouses and dependent children of emergency service personnel and members of the law enforcement officers' and fire fighters' retirement system plan 2 killed in the line of duty" prior to January 1, 1998. The proposed rules will establish conditions for enrollment and participation in PEBB coverage. Chapter 345, Laws of 2006 and authorized under RCW 41.05.080. Local governments, department of retirement systems, and department of labor and industries.
1. July 2006 (expedited filing)

2. Title 182 WAC

3. Barbara Scott, (360) 923-2642

HCA will evaluate and possibly revise retiree eligibility rules to allow retirees to defer their PEBB coverage, based on coverage in a Medicaid program that results from their auto-enrollment in Medicare Part D. HCA will also evaluate revising eligibility rules to allow these retirees' dependents to continue their enrollment in PEBB retiree coverage during the retiree's "deferred" status. No mandate, but authorized under RCW 41.05.065. Department of social and health services.
1. October 2006 (preproposal filing)

2. Title 182 WAC

3. Barbara Scott, (360) 923-2642

HCA will undertake an extensive review of PEBB employee eligibility rules in Title 182 WAC. The purpose of the review is to ensure that PEBB employee eligibility rules are clear rules that can be consistently applied by employers and understood by employees. No mandate, but authorized under RCW 41.05.065. All state and higher education agencies; K-12 school districts and local governments purchasing employee benefits via the PEBB program; department of personnel; and the office of financial management.
1. September 2006

2. CR-101

3. Dolores Reyes-Gonzalez, (360) 923-2781

Allocation of state noncitizen immigrant funds. The legislature created this program to be effective July 1, 2002, through June 30, 2003. Funding specifically for this program was terminated, however, WAC 182-20-250 was not removed making it confusing for some officials and stakeholders. Removing this section will update and clarify chapter 182-20 WAC. None. Department of social and health services.
1. September 2006

2. CR 101

3. Dolores Reyes-Gonzalez, (360) 923-2781 and Jan Olmstead, (360) 923-2803

The health care authority/community health services will be amending chapter 182-20 WAC to incorporate health care collaborative grant program. The legislature created a new program - health care collaborative grant program and appropriated funds in 2005-2007 biennium for initial funding and allocation of the second half of the funds in 2008. The proposed rule will establish requirements to develop a new grant program for innovative programs that target employed low-income persons who are uninsured and underinsured, through local programs addressing one or more of the following:

a. Access to medical treatment.

b. Efficient use of health care resources.

c. Quality care.

Selection criteria, performance measures and annual report will be developed.

No mandate, but authorized under chapter 67, Laws of 2006. DOH, DSHS and OIC.

Other state and local agencies.

1. November 2006

2. Chapter 182-50 WAC

3. Duane Thurman, (206) 521-2036

To be consistent with SSB 5838 (chapter 233, Laws of 2006) health care authority/prescription drug program will amend WAC 182-50-005(9) and 182-50-200 (1)(b) to exempt refills of prescriptions for immunomodulator/antiviral drugs used to treat hepatitis C from therapeutic substitution under WAC 182-50-200. No mandate, but authorized by SSB 5838 (chapter 233, Laws of 2006). DSHS, L&I, DOC.

Cyndi Presnell, Assistant Rules Coordinator, (360) 923-2802.
Washington State Code Reviser's Office