WSR 14-15-104
[Insurance Commissioner Matter No. R 2014-08Filed July 18, 2014, 4:34 p.m.]
Subject of Possible Rule Making: Network access.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060, 48.18.120, 48.20.450, 48.20.460, 48.43.505, 48.43.510, 48.43.515, 48.43.525, 48.43.530, 48.43.535, 48.44.020, 48.44.050, 48.44.080, 48.46.030, 48.46.200, 45 C.F.R. 156.230, 45 C.F.R. 156.235, 45 C.F.R. 156.245.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: Based on the significant changes in health care delivery and access to care occurring after January 1, 2014, due to health care reform, the commissioner determined that further updating of regulations regarding these topics is reasonable and necessary. Clarification of the provider network maintenance and contracting is needed to support issuer filings. Issuers will benefit from written guidance regarding the commissioner's review standards for network maintenance and contracting.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The United States Department of Health and Human Services (HHS) issues regulations implementing the Affordable Care Act. The commissioner's staff will confer with federal counterparts during the rule-making process.
The state health benefit exchange, while not a state agency, certifies qualified health plans to HHS for offering on the exchange. The commissioner will include the exchange in the rule development process as appropriate.
Process for Developing New Rule: Submit written comments by August 22, 2014, to Kate Reynolds,, fax (360) 586-3109.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kate Reynolds, P.O. Box 40258, Olympia, WA 98504-0258, phone (360) 725-7170, fax (360) 586-3109,
July 18, 2014
Mike Kreidler
Insurance Commissioner