HEALTH CARE AUTHORITY
[Filed March 4, 2021, 3:45 p.m., effective April 4, 2021]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The agency is adopting these rules to implement the requirements of SHB 2728 (66th legislature, 2020 regular session). SHB 2728 requires the agency to assess and collect costs to operate and administer the partnership lines established by that legislation.
Citation of Rules Affected by this Order: New WAC 182-110-0100, 182-110-0200, 182-110-0300, 182-110-0400, and 182-110-0500.
Adopted under notice filed as WSR 21-03-074 on January 19, 2021.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 5, Amended 0, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 5, Amended 0, Repealed 0.
Date Adopted: March 4, 2021.
Chapter 182-110 WAC
PARTNERSHIP ACCESS LINE AND PSYCHIATRIC CONSULTATION LINE
(1) The Washington state health care authority (authority), the University of Washington department of psychiatry and behavioral sciences, and Seattle children's hospital administer the partnership access lines described in RCW 71.24.061
, relating to mental health services for children and the treatment of depression in pregnant women and new mothers.
(2) The authority and the University of Washington department of psychiatry and behavioral sciences administer the psychiatric consultation line described in RCW 71.24.062
to give certain providers on-demand access to psychiatric and substance use disorder clinical consultation for adult patients.
(3) The authority or its designee:
(a) Determines the administrative costs for each program identified in subsections (1) and (2) of this section;
(b) Calculates the proportion of clients that are covered by programs administered under chapter 74.09
(c) Collects a proportionate share of program costs that are not for covered lives from the assessed entities under contract with the authority as medicaid managed care organizations.
For the purposes of this chapter:
(1) "Assessed entity" means:
(a) Health carriers, as defined in RCW 48.43.005
(b) Self-funded multiple employer welfare arrangements, as defined in RCW 48.125.010
(c) Employers or other entities that provide health care in Washington, including self-funding entities or employee welfare benefit plans.
(2) "Covered lives" means a Washington resident who is covered by an assessed entity, including an enrollee, subscriber, policyholder, beneficiary of a group plan, or person covered by any other health plan.
WAC 182-110-0300Registration requirements.
(1) An assessed entity must register with the authority or its designee and provide the required contact information. Reporting entities must comply with the authority's or its designee's processes for registering and submitting data, as outlined in the data submission guide published on the authority's or its designee's website.
(2) Reregistration is required only if there is a change in the contact information previously provided. Assessed entities are responsible for maintaining current and accurate contact information with the authority or its designee.
(3) Failure to register and provide or maintain accurate contact information with the authority or its designee may result in an assessed entity's inability to submit required data in compliance with this chapter.
WAC 182-110-0400Data reporting.
(1) Beginning July 1, 2021, no later than the end of forty-five calendar days after the end of each calendar quarter, an assessed entity must submit to the authority or its designee, in the required format, the total number of Washington resident covered lives for each calendar month from the prior quarter.
(2) An assessed entity must immediately notify the authority or its designee if it identifies a covered lives reporting error.
(3) Each assessed entity must collect and maintain the data in a manner consistent with applicable state and federal health information privacy laws.
(4) Failure to report accurate data to the authority or its designee may result in an assessed entity's inability to maintain compliance with this chapter.
Each assessed entity receives a quarterly invoice for its share of the total amount of program costs that are for the proportion of the entity's covered lives. Entities must timely send payment to fund the partnership access lines described in RCW 71.24.061
and the psychiatric consultation line described in RCW 71.24.062