RCW 41.05.004 Intent—Use of word “board.” It is the intent of the legislature that the word “board” be read to mean both the school employees’ benefits board and the public employees’ benefits board throughout this chapter. The use of “board” should be liberally construed to mean both boards, to the extent not in conflict with […]
RCW 41.05.006 Purpose. (1) The legislature recognizes that (a) the state is a major purchaser of health care services, (b) the increasing costs of such health care services are posing and will continue to pose a great financial burden on the state, (c) it is the state’s policy, consistent with the best interests of the […]
RCW 41.05.008 Duties of employing agencies. (1) Every employing agency shall carry out all actions required by the authority under this chapter including, but not limited to, those necessary for the operation of benefit plans, education of employees, claims administration, and appeals process. (2) Employing agencies shall report all data relating to employees eligible to […]
RCW 41.05.009 Determination of employee or school employee eligibility for benefits. (1) The authority, or an employing agency at the authority’s direction, shall initially determine and periodically review whether an employee or a school employee is eligible for benefits pursuant to the criteria established under this chapter. (2) An employing agency shall inform an employee […]
RCW 41.05.0091 Eligibility exists prior to January 1, 2010. An employee determined eligible for benefits prior to January 1, 2010, shall not have his or her eligibility terminated pursuant to the criteria established under chapter 537, Laws of 2009 unless the termination is the result of: (1) A voluntary reduction in work hours; or (2) […]
RCW 41.05.011 Definitions. The definitions in this section apply throughout this chapter unless the context clearly requires otherwise. (1) “Authority” means the Washington state health care authority. (2) “Board” means the public employees’ benefits board established under RCW 41.05.055 and the school employees’ benefits board established under RCW 41.05.740. (3) “Dependent care assistance program” means […]
RCW 41.05.013 State purchased health care programs—Uniform policies—Report to the legislature. (1) The authority shall coordinate state agency efforts to develop and implement uniform policies across state purchased health care programs that will ensure prudent, cost-effective health services purchasing, maximize efficiencies in administration of state purchased health care programs, improve the quality of care provided […]
RCW 41.05.014 Applications, enrollment forms, and eligibility certification documents—Signatures. (1) The director may require applications, enrollment forms, and eligibility certification documents for benefits that are administered by the authority under this chapter and chapter 70.47 RCW to be signed by the person submitting them. The director may accept electronic signatures. (2) For the purpose of […]
RCW 41.05.015 Medical director—Appointment of personnel. The director shall designate a medical director who is licensed under chapter 18.57 or 18.71 RCW. The director shall also appoint such professional personnel and other assistants and employees, including professional medical screeners, as may be reasonably necessary to carry out the provisions of this chapter and chapter 74.09 […]
RCW 41.05.017 Provisions applicable to health plans offered under this chapter. Each health plan that provides medical insurance offered under this chapter, including plans created by insuring entities, plans not subject to the provisions of Title 48 RCW, and plans created under RCW 41.05.140, are subject to the provisions of RCW 48.43.500, 70.02.045, 48.43.505 through […]
RCW 41.05.018 Transfer of certain behavioral health-related powers, duties, and functions from the department of social and health services. (1) The powers, duties, and functions of the department of social and health services pertaining to the behavioral health system and purchasing function of the behavioral health administration, except for oversight and management of state-run mental […]
RCW 41.05.021 State health care authority—Director—Cost control and delivery strategies—Health information technology—Managed competition—Rules. (1) The Washington state health care authority is created within the executive branch. The authority shall have a director appointed by the governor, with the consent of the senate. The director shall serve at the pleasure of the governor. The director may […]
RCW 41.05.022 State agent for purchasing health services—Single community-rated risk pool. (1) The health care authority is hereby designated as the single state agent for purchasing health services. (2) On and after January 1, 1995, at least the following state-purchased health services programs shall be merged into a single, community-rated risk pool: Health benefits for […]
RCW 41.05.023 Chronic care management program—Uniform medical plan—Definitions. (1) The health care authority, in collaboration with the department of health, shall design and implement a chronic care management program for employees and school employees enrolled in the state’s self-insured uniform medical plan. Programs must be evidence based, facilitating the use of information technology to improve […]
RCW 41.05.026 Contracts—Proprietary data, trade secrets, actuarial formulas, statistics, cost and utilization data—Exemption from public inspection—Executive sessions. (1) When soliciting proposals for the purpose of awarding contracts for goods or services, the director shall, upon written request by the bidder, exempt from public inspection and copying such proprietary data, trade secrets, or other information contained […]
RCW 41.05.031 Agencies to establish health care information systems. The following state agencies are directed to cooperate with the authority to establish appropriate health care information systems in their programs: The department of social and health services, the department of health, the department of labor and industries, the basic health plan, the department of veterans […]
RCW 41.05.033 Shared decision-making demonstration project—Preference-sensitive care. (1) The legislature finds that there is growing evidence that, for preference-sensitive care involving elective surgery, patient-practitioner communication is improved through the use of high quality decision aids that detail the benefits, harms, and uncertainty of available treatment options. Improved communication leads to more fully informed patient decisions. […]
RCW 41.05.035 Exchange of health information—Pilot—Advisory board, discretionary—Administrator’s authority. (1) The *administrator shall design and pilot a consumer-centric health information infrastructure and the first health record banks that will facilitate the secure exchange of health information when and where needed and shall: (a) Complete the plan of initial implementation, including but not limited to determining […]
RCW 41.05.036 Health information—Definitions. The definitions in this section apply throughout RCW 41.05.039 through 41.05.046 unless the context clearly requires otherwise. (1) “Director” means the director of the state health care authority under this chapter. (2) “Exchange” means the methods or medium by which health care information may be electronically and securely exchanged among authorized […]
RCW 41.05.037 Nurse hotline, when funded. To the extent that funding is provided specifically for this purpose, the director shall provide all persons enrolled in health plans under this chapter and chapters 70.47 and 74.09 RCW with access to a twenty-four hour, seven day a week nurse hotline. [ 2011 1st sp.s. c 15 § […]
