WSR 16-16-093
[Insurance Commissioner Matter No. R 2016-22—Filed July 29, 2016, 4:31 p.m.]
Subject of Possible Rule Making: Drug substitution request process.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: 45 C.F.R. §155.122(c) sets forward specific processes that health plans must follow in order to provide enrollees with sufficient access to prescription drugs that are not covered by the plan. Rules are necessary to ensure that state law is consistent with federal requirements.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: HHS released the 2017 Notice of Benefit and Payment Parameters setting forth new parameters for a health plan's substitution process. The proposed rules would follow the new parameters.
Process for Developing New Rule: Submit written comments by September 15, 2016, to Jim Freeburg,, 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 Jim Freeburg, P.O. Box 40258, Olympia, WA 98504, (360) 725-7170,
July 29, 2016
Mike Kreidler
Insurance Commissioner