reglab/housing_qa huggingface dataset:
WA Rev Code § 41.05.520 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.520 - Pharmacy connection program—Notice.

RCW 41.05.520 Pharmacy connection program—Notice.(1) The *administrator shall establish and advertise a pharmacy connection program through which health care providers and members of the public can obtain information about manufacturer-sponsored prescription drug assistance programs. The *administrator shall ensure that the program has staff available who can assist persons in procuring free or discounted medications from manufacturer-sponsored prescription drug assistance programs by:(a) Determining whether an assistance program is offered for the needed drug or drugs;(b) Evaluating the likelihood of a person obtaining drugs from an assistance program under the guidelines formulated;(c) Assisting persons with the application and enrollment in an assistance program;(d) Coordinating and assisting physicians and others authorized to prescribe medications with communications, including applications, made on behalf of a person to a participating manufacturer to obtain approval of the person in an assistance program; and(e) Working with participating manufacturers to simplify the system whereby eligible persons access drug assistance programs, including development of a single application form and uniform enrollment process.(2) Notice regarding the pharmacy connection program shall initially target senior citizens, but the program shall be available to anyone, and shall include a toll-free telephone number, available during regular business hours, that may be used to obtain information.(3) The *administrator may apply for and accept grants or gifts and may enter into interagency agreements or contracts with other state agencies or private organizations to assist with the implementation of this program including, but not limited to, contracts, gifts, or grants from pharmaceutical manufacturers to assist with the direct costs of the program.(4) The *administrator shall notify pharmaceutical companies doing business in Washington of the pharmacy connection program. Any pharmaceutical company that does business in this state and that offers a pharmaceutical assistance program shall notify the *administrator of the existence of the program, the drugs covered by the program, and all information necessary to apply for assistance under the program.(5) For purposes of this section, "manufacturer-sponsored prescription drug assistance program" means a program offered by a pharmaceutical company through which the company provides a drug or drugs to eligible persons at no charge or at a reduced cost. The term does not include the provision of a drug as part of a clinical trial.[ 2003 1st sp.s. c 29 § 7.]NOTES:*Reviser's note: The definition for "administrator" was changed to "director" by 2011 1st sp.s. c 15 § 57.Finding—Intent—Severability—Conflict with federal requirements—Effective date—2003 1st sp.s. c 29: See notes following RCW 74.09.650.
WA Rev Code § 41.05.525 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.525 - Treatment of opioid use disorder—Prior authorization.

RCW 41.05.525 Treatment of opioid use disorder—Prior authorization.A health plan offered to employees, school employees, and their covered dependents under this chapter issued or renewed on or after January 1, 2020, shall provide coverage without prior authorization of at least one federal food and drug administration approved product for the treatment of opioid use disorder in the drug classes opioid agonists, opioid antagonists, and opioid partial agonists.[ 2019 c 314 § 36.]NOTES:Declaration—2019 c 314: See note following RCW 18.22.810.
WA Rev Code § 41.05.527 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.527 - Opioid overdose reversal medication bulk purchasing and distribution program.

RCW 41.05.527 Opioid overdose reversal medication bulk purchasing and distribution program.A health plan offered to public employees and their covered dependents under this chapter that is issued or renewed on or after January 1, 2023, must participate in the bulk purchasing and distribution program for opioid overdose reversal medication established in RCW 70.14.170 once the program is operational.[ 2021 c 273 § 10.]NOTES:Rules—2021 c 273 §§ 7-12: See note following RCW 70.14.170.Findings—Intent—2021 c 273: See note following RCW 70.41.480.
WA Rev Code § 41.05.528 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.528 - Standard set of criteria—Medical necessity for substance use disorder treatment—Substance use disorder levels of care—Rules.

RCW 41.05.528 Standard set of criteria—Medical necessity for substance use disorder treatment—Substance use disorder levels of care—Rules.For the purposes of promoting standardized training for behavioral health professionals and facilitating communications between behavioral health agencies, executive agencies, managed care organizations, private health plans, and plans offered through the public employees' benefits board, it is the policy of the state to adopt a single standard set of criteria to define medical necessity for substance use disorder treatment and to define substance use disorder levels of care in Washington. The criteria selected must be comprehensive, widely understood and accepted in the field, and based on continuously updated research and evidence. The health care authority and the office of the insurance commissioner must independently review their regulations and practices by January 1, 2021. The health care authority may make rules if necessary to promulgate the selected standard set of criteria.[ 2020 c 345 § 6.]NOTES:Findings—Intent—2020 c 345: See note following RCW 41.05.526.
WA Rev Code § 41.05.530 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.530 - Prescription drug assistance, education—Rules.

RCW 41.05.530 Prescription drug assistance, education—Rules.The authority may adopt rules to implement chapter 29, Laws of 2003 1st sp. sess.[ 2003 1st sp.s. c 29 § 10.]NOTES:Finding—Intent—Severability—Conflict with federal requirements—Effective date—2003 1st sp.s. c 29: See notes following RCW 74.09.650.
WA Rev Code § 41.05.533 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.533 - Medication synchronization policy required for health benefit plans covering prescription drugs—Requirements—Definitions.

RCW 41.05.533 Medication synchronization policy required for health benefit plans covering prescription drugs—Requirements—Definitions.(1) A health benefit plan offered to public employees and their covered dependents under this chapter that is not subject to chapter 48.43 RCW, that is issued or renewed after December 31, 2015, and that provides coverage for prescription drugs must implement a medication synchronization policy for the dispensing of prescription drugs to the plan's enrollees.(a) If an enrollee requests medication synchronization for a new prescription, the health [benefit] plan must permit filling the drug: (i) For less than a one-month supply of the drug if synchronization will require more than a fifteen-day supply of the drug; or (ii) for more than a one-month supply of the drug if synchronization will require a fifteen-day supply of the drug or less.(b) The health benefit plan shall adjust the enrollee cost-sharing for a prescription drug subject to coinsurance that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications.(c) The health benefit plan shall adjust the enrollee cost-sharing for a prescription drug with a copayment that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications by:(i) Discounting the copayment rate by fifty percent;(ii) Discounting the copayment rate based on fifteen-day increments; or(iii) Any other method that meets the intent of this section and is approved by the office of the insurance commissioner.(2) Upon request of an enrollee, the prescribing provider or pharmacist shall:(a) Determine that filling or refilling the prescription is in the best interest of the enrollee, taking into account the appropriateness of synchronization for the drug being dispensed;(b) Inform the enrollee that the prescription will be filled to less than the standard refill amount for the purpose of synchronizing his or her medications; and(c) Deny synchronization on the grounds of threat to patient safety or suspected fraud or abuse.(3) For purposes of this section, the following terms have the following meanings unless the context clearly requires otherwise:(a) "Medication synchronization" means the coordination of medication refills for a patient taking two or more medications for a chronic condition such that the patient's medications are refilled on the same schedule for a given time period. (b) "Prescription" has the same meaning as in RCW 18.64.011.[ 2015 c 213 § 2.]
WA Rev Code § 41.05.540 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.540 - State employee health program—Requirements—Report.

RCW 41.05.540 State employee health program—Requirements—Report.(1) The health care authority, in coordination with the department of health, health plans participating in public employees' benefits board programs, and the University of Washington's center for health promotion, shall establish and maintain a state employee health program focused on reducing the health risks and improving the health status of state employees, dependents, and retirees enrolled in the public employees' benefits board. The program shall use public and private sector best practices to achieve goals of measurable health outcomes, measurable productivity improvements, positive impact on the cost of medical care, and positive return on investment. The program shall establish standards for health promotion and disease prevention activities, and develop a mechanism to update standards as evidence-based research brings new information and best practices forward.(2) The state employee health program shall:(a) Provide technical assistance and other services as needed to wellness staff in all state agencies and institutions of higher education;(b) Develop effective communication tools and ongoing training for wellness staff;(c) Contract with outside vendors for evaluation of program goals;(d) Strongly encourage the widespread completion of online health assessment tools for all state employees, dependents, and retirees. The health assessment tool must be voluntary and confidential. Health assessment data and claims data shall be used to:(i) Engage state agencies and institutions of higher education in providing evidence-based programs targeted at reducing identified health risks;(ii) Guide contracting with third-party vendors to implement behavior change tools for targeted high-risk populations; and(iii) Guide the benefit structure for state employees, dependents, and retirees to include covered services and medications known to manage and reduce health risks.(3) The health care authority shall report to the legislature in December 2008 and December 2010 on outcome goals for the employee health program.[ 2007 c 259 § 40; 2005 c 360 § 8.]NOTES:Severability—Subheadings not law—2007 c 259: See notes following RCW 41.05.033.Findings—Intent—2005 c 360: See note following RCW 36.70A.070.
WA Rev Code § 41.05.601 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.601 - Mental health services—Rules.

RCW 41.05.601 Mental health services—Rules.The *administrator may adopt rules to implement RCW 41.05.600.[ 2005 c 6 § 12.]NOTES:*Reviser's note: The definition for "administrator" was changed to "director" by 2011 1st sp.s. c 15 § 57.Findings—Intent—Severability—2005 c 6: See notes following RCW 41.05.600.
WA Rev Code § 41.05.630 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.630 - Annual report of customer service complaints and appeals.

RCW 41.05.630 Annual report of customer service complaints and appeals.Beginning in 2011, the state health care authority must process as a complaint an enrollee's expression of dissatisfaction about customer service or the quality or availability of a health service. The agency must require that 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 must submit a summary of customer service complaints and appeals to the agency to be included in an annual report to the legislature. Each annual report must summarize the complaints and appeals processed by the state health care authority and contracted carriers in the preceding twelve months, and include an analysis of any trends identified. The report must be complete by September 30th of each year.[ 2010 c 293 § 1.]
WA Rev Code § 41.05.650 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.650 - Community health care collaborative grant program—Grants—Administrative support—Eligibility.

RCW 41.05.650 Community health care collaborative grant program—Grants—Administrative support—Eligibility.(1) The community health care collaborative grant program is established to further the efforts of community-based coalitions to increase access to appropriate, affordable health care for Washington residents, particularly employed low-income persons and children in school who are uninsured and underinsured, through local programs addressing one or more of the following: (a) Access to medical treatment; (b) the efficient use of health care resources; and (c) quality of care.(2) Consistent with funds appropriated for community health care collaborative grants specifically for this purpose, two-year grants may be awarded pursuant to RCW 41.05.660 by the *administrator of the health care authority.(3) The health care authority shall provide administrative support for the program. Administrative support activities may include health care authority facilitation of statewide discussions regarding best practices and standardized performance measures among grantees, or subcontracting for such discussions.(4) Eligibility for community health care collaborative grants shall be limited to nonprofit organizations established to serve a defined geographic region or organizations with public agency status under the jurisdiction of a local, county, or tribal government. To be eligible, such entities must have a formal collaborative governance structure and decision-making process that includes representation by the following health care providers: Hospitals, public health, behavioral health, community health centers, rural health clinics, and private practitioners that serve low-income persons in the region, unless there are no such providers within the region, or providers decline or refuse to participate or place unreasonable conditions on their participation. The nature and format of the application, and the application procedure, shall be determined by the *administrator of the health care authority. At a minimum, each application shall: (a) Identify the geographic region served by the organization; (b) show how the structure and operation of the organization reflects the interests of, and is accountable to, this region and members providing care within this region; (c) indicate the size of the grant being requested, and how the money will be spent; and (d) include sufficient information for an evaluation of the application based on the criteria established in RCW 41.05.660.[ 2009 c 299 § 1.]NOTES:*Reviser's note: The definition for "administrator" was changed to "director" by 2011 1st sp.s. c 15 § 57.
WA Rev Code § 41.05.651 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.651 - Rules—2009 c 299.

RCW 41.05.651 Rules—2009 c 299.The health care authority may adopt rules to implement chapter 299, Laws of 2009.[ 2009 c 299 § 4.]
WA Rev Code § 41.05.670 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.670 - Chronic care management incentives—Provider reimbursement methods.

RCW 41.05.670 Chronic care management incentives—Provider reimbursement methods.(1) Effective January 1, 2013, the authority must contract with all of the public employees' benefits board managed care plans and the self-insured plan or plans to include provider reimbursement methods that incentivize chronic care management within health homes resulting in reduced emergency department and inpatient use.(2) Health home services contracted for under this section may be prioritized to enrollees with complex, high cost, or multiple chronic conditions.(3) For the purposes of this section, "chronic care management" and "health home" have the same meaning as in RCW 74.09.010.(4) Contracts with fully insured plans and with any third-party administrator for the self-funded plan that include the items in subsection (1) of this section must be funded within the resources provided by employer funding rates provided for employee health benefits in the omnibus appropriations act.(5) Nothing in this section shall require contracted third-party health plans administering the self-insured contract to expend resources to implement items in subsection (1) of this section beyond the resources provided by employer funding rates provided for employee health benefits in the omnibus appropriations act or from other sources in the absence of these provisions.(6) The school employees' benefits board, under RCW 41.05.740, shall implement the provisions of this section, effective January 1, 2020.[ 2017 3rd sp.s. c 13 § 812; 2011 c 316 § 6.]NOTES:Intent—2017 3rd sp.s. c 13: See note following RCW 28A.150.410.
WA Rev Code § 41.05.680 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.680 - Report—Chronic care management.

RCW 41.05.680 Report—Chronic care management.The authority shall coordinate a discussion with carriers to learn from successful chronic care management models and develop principles for effective reimbursement methods to align incentives in support of patient centered chronic care health homes. The authority shall submit a report to the appropriate committees of the legislature by December 1, 2012, describing the principles developed from the discussion and any steps taken by the public employees' benefits board or carriers in Washington state to implement the principles through their payment methodologies.[ 2011 c 316 § 7.]
WA Rev Code § 41.05.742 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.742 - Single enrollment requirement.

RCW 41.05.742 Single enrollment requirement.Beginning with the 2022 plan year, individuals are limited to a single enrollment in medical, dental, and vision plans in either the school employees' benefits board or the public employees' benefits board. The school employees' benefits board and the public employees' benefits board shall adopt policies to reflect this single enrollment requirement.[ 2021 c 18 § 1; 2020 c 8 § 4.]NOTES:Effective date—2020 c 8: See note following RCW 41.05.744.
WA Rev Code § 41.05.744 (2021)
2021 Revised Code of Washington|Title 41 - Public Employment, Civil Service, and Pensions|Chapter 41.05 - State Health Care Authority.|41.05.744 - School employee eligibility during COVID-19 state of emergency.

RCW 41.05.744 School employee eligibility during COVID-19 state of emergency.(1) A school employee eligible as of February 29, 2020, for the employer contribution towards benefits offered by the school employees' benefits board shall maintain their eligibility for the employer contribution under the following circumstances directly related or in response to the governor's February 29, 2020, proclamation of a state of emergency existing in all counties in the state of Washington related to the novel coronavirus (COVID-19):(a) During any school closures or changes in school operations for the school employee;(b) While the school employee is quarantined or required to care for a family member, as defined by RCW 49.46.210(2), who is quarantined; and(c) In order to take care of a child as defined by RCW 49.46.210(2), when the child's:(i) School is closed;(ii) Regular day care facility is closed; or(iii) Regular child care provider is unable to provide services.(2) Requirements in subsection (1) of this section expires when the governor's state of emergency related to the novel coronavirus (COVID-19) ends.(3) When regular school operations resume, school employees shall continue to maintain their eligibility for the employer contribution for the remainder of the school year so long as their work schedule returns to the schedule in place before February 29, 2020, or, if there is a change in schedule, so long as the new schedule, had it been in effect at the start of the school year, would have resulted in the employee being anticipated to work the minimum hours to meet benefits eligibility.(4) Quarantine, as used in subsection (1)(b) [of this section] includes only periods of isolation required by the federal government, a foreign national government, a state or local public health official, a health care provider, or an employer.[ 2020 c 8 § 5.]NOTES:Effective date—2020 c 8: "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 [March 17, 2020]." [ 2020 c 8 § 6.]