reglab/housing_qa huggingface dataset:
WA Rev Code § 48.46.510 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.510 - Phenylketonuria.

RCW 48.46.510 Phenylketonuria.(1) The legislature finds that:(a) Phenylketonuria is a rare inherited genetic disorder.(b) Children with phenylketonuria are unable to metabolize an essential amino acid, phenylalanine, which is found in the proteins of most food.(c) To remain healthy, children with phenylketonuria must maintain a strict diet and ingest a mineral and vitamin-enriched formula.(d) Children who do not maintain their diets with the formula acquire severe mental and physical difficulties.(e) Originally, the formulas were listed as prescription drugs but were reclassified as medical foods to increase their availability.(2) Subject to requirements and exceptions which may be established by rules adopted by the commissioner, any agreement for health care services delivered or issued for delivery or renewed in this state on or after September 1, 1988, shall provide coverage for the formulas necessary for the treatment of phenylketonuria. Such formulas shall be covered when deemed medically necessary by the medical director or his or her designee of the health maintenance organization and if provided by the health maintenance organization or upon the health maintenance organization's referral. Formulas shall be covered at the usual and customary rates for such formulas, subject to contract provisions with respect to deductible amounts or copayments.[ 1988 c 173 § 4.]
WA Rev Code § 48.46.520 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.520 - Neurodevelopmental therapies—Employer-sponsored group contracts.

RCW 48.46.520 Neurodevelopmental therapies—Employer-sponsored group contracts.(1) Each employer-sponsored group contract for comprehensive health care service which is entered into, or renewed, on or after twelve months after July 23, 1989, shall include coverage for neurodevelopmental therapies for covered individuals age six and under.(2) Benefits provided under this section shall cover the services of those authorized to deliver occupational therapy, speech therapy, and physical therapy. Covered benefits and treatment must be rendered or referred by the health maintenance organization, and delivered pursuant to the referral and periodic review of a holder of a license issued pursuant to chapter 18.71 or 18.57 RCW or where treatment is rendered by such licensee. Nothing in this section shall prohibit a health maintenance organization from negotiating rates with qualified providers.(3) Benefits provided under this section shall be for medically necessary services as determined by the health maintenance organization. Benefits shall be provided for the maintenance of a covered enrollee in cases where significant deterioration in the patient's condition would result without the service. Benefits shall be provided to restore and improve function.(4) It is the intent of this section that employers purchasing comprehensive group coverage including the benefits required by this section, together with the health maintenance organization, retain authority to design and employ utilization and cost controls. Therefore, benefits provided under this section may be subject to contractual provisions regarding deductible amounts and/or copayments established by the employer purchasing coverage and the health maintenance organization. Benefits provided under this section may be subject to standard waiting periods for preexisting conditions, and may be subject to the submission of written treatment plans.(5) In recognition of the intent expressed in subsection (4) of this section, benefits provided under this section may be subject to contractual provisions establishing annual and/or lifetime benefit limits. Such limits may define the total dollar benefits available, or may limit the number of services delivered as agreed by the employer purchasing coverage and the health maintenance organization.[ 1989 c 345 § 3.]
WA Rev Code § 48.46.530 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.530 - Temporomandibular joint disorders—Insurance coverage.

RCW 48.46.530 Temporomandibular joint disorders—Insurance coverage.(1) Except as provided in this section, a health maintenance agreement entered into or renewed after December 31, 1989, shall offer optional coverage for the treatment of temporomandibular joint disorders.(a) Health maintenance organizations offering medical coverage only may limit benefits in such coverages to medical services related to treatment of temporomandibular joint disorders. No health maintenance organizations offering medical and dental coverage may limit benefits in such coverage to dental services related to treatment of temporomandibular joint disorders. No health maintenance organization offering medical coverage only may define all temporomandibular joint disorders as purely dental in nature.(b) Health maintenance organizations offering optional temporomandibular joint disorder coverage as provided in this section may, but are not required to, offer lesser or no temporomandibular joint disorder coverage as part of their basic group disability contract.(c) Benefits and coverage offered under this section may be subject to negotiation to promote broad flexibility in potential benefit coverage. This flexibility shall apply to services to be reimbursed, determination of treatments to be considered medically necessary, systems through which services are to be provided, including referral systems and use of other providers, and related issues.(2) Unless otherwise directed by law, the insurance commissioner shall adopt rules, to be implemented on January 1, 1993, establishing minimum benefits, terms, definitions, conditions, limitations, and provisions for the use of reasonable deductibles and copayments.(3) A health maintenance organization need not make the offer of coverage required by this section to an employer or other group that offers to its eligible enrollees a self-insured health plan not subject to mandated benefit statutes under Title 48 RCW that does not provide coverage for temporomandibular joint disorders.[ 1989 c 331 § 4.]NOTES:Legislative finding—Effective date—1989 c 331: See notes following RCW 48.21.320.
WA Rev Code § 48.46.535 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.535 - Prescriptions—Preapproval of individual claims—Subsequent rejection prohibited—Written record required.

RCW 48.46.535 Prescriptions—Preapproval of individual claims—Subsequent rejection prohibited—Written record required.Health maintenance organizations who through an authorized representative have first approved, by any means, an individual prescription claim as eligible may not reject that claim at some later date. Pharmacists or drug dispensing outlets who obtain preapproval of claims shall keep a written record of the preapproval that consists of identification by name and telephone number of the person who approved the claim.[ 1993 c 253 § 5.]NOTES:Findings—Effective date—1993 c 253: See notes following RCW 48.20.525.
WA Rev Code § 48.46.540 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.540 - Nonresident pharmacies.

RCW 48.46.540 Nonresident pharmacies.For the purposes of this chapter, a nonresident pharmacy is defined as any pharmacy located outside this state that ships, mails, or delivers, in any manner, except when delivered in person to an enrolled participant or his/her representative, controlled substances, legend drugs, or devices into this state.After October 1, 1991, a health maintenance organization providing coverage of prescription drugs from nonresident pharmacies may only provide coverage from licensed nonresident pharmacies. The health maintenance organizations shall obtain proof of current licensure in conformity with this section and RCW 18.64.350 through 18.64.400 from the nonresident pharmacy and keep that proof of licensure on file.The department may request from the health maintenance organization the proof of current licensure for all nonresident pharmacies through which the insurer is providing coverage for prescription drugs for residents of the state of Washington. This information, which may constitute a full or partial customer list, shall be confidential and exempt from public disclosure, and from the requirements of chapter 42.56 RCW. The board or the department shall not be restricted in the disclosure of the name of a nonresident pharmacy that is or has been licensed under RCW 18.64.360 or 18.64.370 or of the identity of a nonresident pharmacy disciplined under RCW 18.64.350 through 18.64.400.[ 2005 c 274 § 315; 1991 c 87 § 10.]NOTES:Effective date—1991 c 87: See note following RCW 18.64.350.
WA Rev Code § 48.46.565 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.565 - Foot care services.

RCW 48.46.565 Foot care services.Except to the extent that a health maintenance organization contracts with a group medical practice which only treats that organization's patients, a health maintenance organization may not discriminate in the terms and conditions, including reimbursement, for the provision of foot care services between physicians and surgeons licensed under chapters 18.22, 18.57, and 18.71 RCW.[ 1999 c 64 § 1.]NOTES:Intent—1999 c 64: "This act is intended to be procedural and not to impair the obligation of any existing contract." [ 1999 c 64 § 2.]Severability—1999 c 64: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 1999 c 64 § 3.]
WA Rev Code § 48.46.570 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.570 - Denturist services.

RCW 48.46.570 Denturist services.Notwithstanding any provision of any health maintenance organization agreement covering dental care as provided for in this chapter, effective January 1, 1995, benefits shall not be denied thereunder for any service performed by a denturist licensed under chapter 18.30 RCW if (1) the service performed was within the lawful scope of such person's license, and (2) such agreement would have provided benefits if such service had been performed by a dentist licensed under chapter 18.32 RCW.[ 1995 c 1 § 25 (Initiative Measure No. 607, approved November 8, 1994).]NOTES:Short title—1995 c 1 (Initiative Measure No. 607): See RCW 18.30.900.
WA Rev Code § 48.46.575 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.575 - Doctor of osteopathic medicine and surgery—Discrimination based on board certification is prohibited.

RCW 48.46.575 Doctor of osteopathic medicine and surgery—Discrimination based on board certification is prohibited.A health maintenance organization that provides health care services to the general public may not discriminate against a qualified doctor of osteopathic medicine and surgery licensed under chapter 18.57 RCW, who has applied to practice with the health maintenance organization, solely because that practitioner was board certified or eligible under an approved osteopathic certifying board instead of board certified or eligible respectively under an approved medical certifying board.[ 1995 c 64 § 1.]
WA Rev Code § 48.46.580 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.580 - When injury caused by intoxication or use of narcotics.

RCW 48.46.580 When injury caused by intoxication or use of narcotics.A health maintenance organization may not deny coverage for the treatment of an injury solely because the injury was sustained as a consequence of the enrolled participant's being intoxicated or under the influence of a narcotic.[ 2004 c 112 § 5.]NOTES:Finding—Application—2004 c 112: See notes following RCW 48.20.385.
WA Rev Code § 48.46.600 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.600 - Disclosure of certain material transactions—Report—Information is confidential.

RCW 48.46.600 Disclosure of certain material transactions—Report—Information is confidential.(1) Every health maintenance organization domiciled in this state shall file a report with the commissioner disclosing material acquisitions and dispositions of assets or material nonrenewals, cancellations, or revisions of ceded reinsurance agreements unless these acquisitions and dispositions of assets or material nonrenewals, cancellations, or revisions of ceded reinsurance agreements have been submitted to the commissioner for review, approval, or information purposes under other provisions of this title or other requirements.(2) The report required in subsection (1) of this section is due within fifteen days after the end of the calendar month in which any of the transactions occur.(3) One complete copy of the report, including any exhibits or other attachments filed as part of the report, shall be filed with the:(a) Commissioner; and(b) National association of insurance commissioners.(4) All reports obtained by or disclosed to the commissioner under this section and RCW 48.46.605 through 48.46.625 are exempt from public inspection and copying and shall not be subject to subpoena. These reports shall not be made public by the commissioner, the national association of insurance commissioners, or any other person, except to insurance departments of other states, without the prior written consent of the health maintenance organization to which it pertains unless the commissioner, after giving the health maintenance organization that would be affected by disclosure notice and a hearing under chapter 48.04 RCW, determines that the interest of policyholders, subscribers, shareholders, or the public will be served by the publication, in which event the commissioner may publish all or any part of the report in the manner he or she deems appropriate.[ 1995 c 86 § 19.]
WA Rev Code § 48.46.605 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.605 - Material acquisitions or dispositions.

RCW 48.46.605 Material acquisitions or dispositions.No acquisitions or dispositions of assets need be reported pursuant to RCW 48.46.600 if the acquisitions or dispositions are not material. For purposes of RCW 48.46.600 through 48.46.625, a material acquisition, or the aggregate of any series of related acquisitions during any thirty-day period; or disposition, or the aggregate of any series of related dispositions during any thirty-day period is an acquisition or disposition that is nonrecurring and not in the ordinary course of business and involves more than five percent of the reporting health maintenance organization's total assets as reported in its most recent statutory statement filed with the commissioner.[ 1995 c 86 § 20.]
WA Rev Code § 48.46.610 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.610 - Asset acquisitions—Asset dispositions.

RCW 48.46.610 Asset acquisitions—Asset dispositions.(1) Asset acquisitions subject to RCW 48.46.600 through 48.46.625 include every purchase, lease, exchange, merger, consolidation, succession, or other acquisition other than the construction or development of real property by or for the reporting health maintenance organization or the acquisition of materials for such purpose.(2) Asset dispositions subject to RCW 48.46.600 through 48.46.625 include every sale, lease, exchange, merger, consolidation, mortgage, hypothecation, abandonment, destruction, other disposition, or assignment, whether for the benefit of creditors or otherwise.[ 1995 c 86 § 21.]
WA Rev Code § 48.46.615 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.615 - Report of a material acquisition or disposition of assets—Information required.

RCW 48.46.615 Report of a material acquisition or disposition of assets—Information required.The following information is required to be disclosed in any report of a material acquisition or disposition of assets:(1) Date of the transaction;(2) Manner of acquisition or disposition;(3) Description of the assets involved;(4) Nature and amount of the consideration given or received;(5) Purpose of or reason for the transaction;(6) Manner by which the amount of consideration was determined;(7) Gain or loss recognized or realized as a result of the transaction; and(8) Names of the persons from whom the assets were acquired or to whom they were disposed.[ 1995 c 86 § 22.]
WA Rev Code § 48.46.620 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.620 - Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.

RCW 48.46.620 Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.(1) No nonrenewals, cancellations, or revisions of ceded reinsurance agreements need be reported under RCW 48.46.600 if the nonrenewals, cancellations, or revisions are not material. For purposes of RCW 48.46.600 through 48.46.625, a material nonrenewal, cancellation, or revision is one that affects:(a) More than fifty percent of a health maintenance organization's total reserve credit taken for business ceded, on an annualized basis, as indicated in the health maintenance organization's most recent annual statement;(b) More than ten percent of a health maintenance organization's total cession when it is replaced by one or more unauthorized reinsurers; or(c) Previously established collateral requirements, when they have been reduced or waived as respects one or more unauthorized reinsurers representing collectively more than ten percent of a total cession.(2) However, a filing is not required if a health maintenance organization's total reserve credit taken for business ceded represents, on an annualized basis, less than ten percent of the statutory reserve requirement prior to any cession.[ 1995 c 86 § 23.]
WA Rev Code § 48.46.625 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.625 - Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements—Information required.

RCW 48.46.625 Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements—Information required.The following is required to be disclosed in any report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements:(1) The effective date of the nonrenewal, cancellation or revision;(2) The description of the transaction with an identification of the initiator;(3) The purpose of or reason for the transaction; and(4) If applicable, the identity of the replacement reinsurers.[ 1995 c 86 § 24.]
WA Rev Code § 48.46.900 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.900 - Liberal construction.

RCW 48.46.900 Liberal construction.It is intended that the provisions of this chapter shall be liberally construed to accomplish the purposes provided for and authorized herein.[ 1975 1st ex.s. c 290 § 24.]
WA Rev Code § 48.46.920 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.920 - Short title.

RCW 48.46.920 Short title.This 1975 amendatory act may be known and cited as "The Washington Health Maintenance Organization Act of 1975".[ 1975 1st ex.s. c 290 § 27.]
WA Rev Code § 48.46.930 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.930 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.

RCW 48.46.930 Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.For the purposes of this chapter, the terms spouse, marriage, marital, husband, wife, widow, widower, next of kin, and family shall be interpreted as applying equally to state registered domestic partnerships or individuals in state registered domestic partnerships as well as to marital relationships and married persons, and references to dissolution of marriage shall apply equally to state registered domestic partnerships that have been terminated, dissolved, or invalidated, to the extent that such interpretation does not conflict with federal law. Where necessary to implement chapter 521, Laws of 2009, gender-specific terms such as husband and wife used in any statute, rule, or other law shall be construed to be gender neutral, and applicable to individuals in state registered domestic partnerships.[ 2009 c 521 § 127.]
WA Rev Code § 48.47.005 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.47 - Mandated Health Benefits.|48.47.005 - Legislative findings—Purpose.

RCW 48.47.005 Legislative findings—Purpose.The legislature finds that there is a continued interest in mandating certain health coverages or offering of health coverages by health carriers; and that improved access to these health care services to segments of the population which desire them can provide beneficial social and health consequences which may be in the public interest.The legislature finds further, however, that the cost ramifications of expanding health coverages is of continuing concern; and that the merits of a particular mandated benefit must be balanced against a variety of consequences which may go far beyond the immediate impact upon the cost of insurance coverage. The legislature hereby finds and declares that a systematic review of proposed mandated benefits, which explores all the ramifications of such proposed legislation, will assist the legislature in determining whether mandating a particular coverage or offering is in the public interest. The purpose of this chapter is to establish a procedure for the proposal, review, and determination of mandated benefit necessity.[ 1997 c 412 § 1; 1984 c 56 § 1. Formerly RCW 48.42.060.]
WA Rev Code § 48.47.020 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.47 - Mandated Health Benefits.|48.47.020 - Submission of mandated health benefit proposal—Review—Benefit must be authorized by law.

RCW 48.47.020 Submission of mandated health benefit proposal—Review—Benefit must be authorized by law.Mandated health benefits shall be established as follows:(1) Every person who, or organization that, seeks to establish a mandated benefit shall, at least ninety days prior to a regular legislative session, submit a mandated benefit proposal to the appropriate committees of the legislature, assessing the social impact, financial impact, and evidence of health care service efficacy of the benefit in strict adherence to the criteria enumerated in RCW 48.47.030.(2) The chair of a committee may request that the department examine the proposal using the criteria set forth in RCW 48.47.030, however, such request must be made no later than nine months prior to a subsequent regular legislative session.(3) To the extent that funds are appropriated for this purpose, the department shall report to the appropriate committees of the legislature on the appropriateness of adoption no later than thirty days prior to the legislative session during which the proposal is to be considered.(4) Mandated benefits must be authorized by law.[ 1997 c 412 § 3; 1989 1st ex.s. c 9 § 221; 1987 c 150 § 79; 1984 c 56 § 2. Formerly RCW 48.42.070.]NOTES:Effective date—Severability—1989 1st ex.s. c 9: See RCW 43.70.910 and 43.70.920.Severability—1987 c 150: See RCW 18.122.901.