Source: http://apps.leg.wa.gov/RCW/default.aspx?cite=74.09.522
Timestamp: 2017-12-13 17:05:01
Document Index: 408945586

Matched Legal Cases: ['§ 1', '§ 55', '§ 13', '§ 2', '§ 29', '§ 2', '§ 4', '§ 15', '§ 1', '§ 2', '§ 21', '§ 2', '§ 3', '§ 1']

RCW 74.09.522: Medical assistance—Agreements with managed health care systems required for services to recipients of temporary assistance for needy families—Principles to be applied in purchasing managed health care—Expiration of subsections.
RCWs > Title 74 > Chapter 74.09 > Section 74.09.522
74.09.521 << 74.09.522 >> 74.09.5222
RCW 74.09.522
Medical assistance—Agreements with managed health care systems required for services to recipients of temporary assistance for needy families—Principles to be applied in purchasing managed health care—Expiration of subsections.
(e)(i) In negotiating with managed health care systems the authority shall adopt a uniform procedure to enter into contractual arrangements, to be included in contracts issued or renewed on or after January 1, 2015, including:
(7) By April 1, 2016, any contract with a managed health care system to provide services to medical assistance enrollees shall require that managed health care systems offer contracts to behavioral health organizations, mental health providers, or chemical dependency treatment providers to provide access to primary care services integrated into behavioral health clinical settings, for individuals with behavioral health and medical comorbidities.
(8) Managed health care system contracts effective on or after April 1, 2016, shall serve geographic areas that correspond to the regional service areas established in RCW 43.20A.893.
(9) A managed health care system shall pay a nonparticipating provider that provides a service covered under this chapter to the system's enrollee no more than the lowest amount paid for that service under the managed health care system's contracts with similar providers in the state if the managed health care system has made good faith efforts to contract with the nonparticipating provider.
(10) For services covered under this chapter to medical assistance or medical care services enrollees and provided on or after August 24, 2011, nonparticipating providers must accept as payment in full the amount paid by the managed health care system under subsection (9) of this section in addition to any deductible, coinsurance, or copayment that is due from the enrollee for the service provided. An enrollee is not liable to any nonparticipating provider for covered services, except for amounts due for any deductible, coinsurance, or copayment under the terms and conditions set forth in the managed health care system contract to provide services under this section.
(13) Subsections (9) through (11) of this section expire July 1, 2021.
[ 2015 c 256 § 1; 2014 c 225 § 55; 2013 2nd sp.s. c 17 § 13; 2013 c 261 § 2. Prior: 2011 1st sp.s. c 15 § 29; 2011 1st sp.s. c 9 § 2; 2011 c 316 § 4; prior: 1997 c 59 § 15; 1997 c 34 § 1; 1989 c 260 § 2; 1987 1st ex.s. c 5 § 21; 1986 c 303 § 2.]
Effective date—1997 c 34: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [April 16, 1997]." [ 1997 c 34 § 3.]
Legislative findings—Intent—1986 c 303: "(1) The legislature finds that:
(a) Good health care for indigent persons is of importance to the state;
(b) To ensure the availability of a good level of health care, efforts must be made to encourage cost consciousness on the part of providers and consumers, while maintaining medical assistance recipients within the mainstream of health care delivery;
(c) Managed health care systems have been found to be effective in controlling costs while providing good health care services;
(d) By enrolling medical assistance recipients within managed health care systems, the state's goal is to ensure that medical assistance recipients receive at least the same quality of care they currently receive.
(2) It is the intent of the legislature to develop and implement new strategies that promote the use of managed health care systems for medical assistance recipients by establishing prepaid capitated programs for both inpatient and outpatient services." [ 1986 c 303 § 1.]