reglab/housing_qa huggingface dataset:
WA Rev Code § 48.49.003 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.003 - Findings—Intent—2019 c 427.

RCW 48.49.003 Findings—Intent—2019 c 427.(1) The legislature finds that:(a) Consumers receive surprise bills or balance bills for services provided at out-of-network facilities or by out-of-network health care providers at in-network facilities;(b) Consumers must not be placed in the middle of contractual disputes between providers and health insurance carriers; and(c) Facilities, providers, and health insurance carriers all share responsibility to ensure consumers have transparent information on network providers and benefit coverage, and the insurance commissioner is responsible for ensuring that provider networks include sufficient numbers and types of contracted providers to reasonably ensure consumers have in-network access for covered benefits.(2) It is the intent of the legislature to:(a) Ban balance billing of consumers enrolled in fully insured, regulated insurance plans and plans offered to public employees under chapter 41.05 RCW for the services described in RCW 48.49.020, and to provide self-funded group health plans with an option to elect to be subject to the provisions of chapter 427, Laws of 2019;(b) Remove consumers from balance billing disputes and require that out-of-network providers and carriers negotiate out-of-network payments in good faith under the terms of chapter 427, Laws of 2019; and(c) Provide an environment that encourages self-funded groups to negotiate out-of-network payments in good faith with providers and facilities in return for balance billing protections.[ 2019 c 427 § 1.]
WA Rev Code § 48.49.005 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.005 - Short title.

RCW 48.49.005 Short title.This chapter may be known and cited as the balance billing protection act.[ 2019 c 427 § 4.]
WA Rev Code § 48.49.010 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.010 - Definitions.

RCW 48.49.010 Definitions.The definitions in RCW 48.43.005 apply throughout this chapter unless the context clearly requires otherwise.[ 2019 c 427 § 5.]
WA Rev Code § 48.49.020 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.020 - Balance billing—When prohibited—Carrier's duty to hold an enrollee harmless from balance billing under certain circumstances.

RCW 48.49.020 Balance billing—When prohibited—Carrier's duty to hold an enrollee harmless from balance billing under certain circumstances.(1) An out-of-network provider or facility may not balance bill an enrollee for the following health care services:(a) Emergency services provided to an enrollee; or(b) Nonemergency health care services provided to an enrollee at an in-network hospital licensed under chapter 70.41 RCW or an in-network ambulatory surgical facility licensed under chapter 70.230 RCW if the services:(i) Involve surgical or ancillary services; and(ii) Are provided by an out-of-network provider.(2) Payment for services described in subsection (1) of this section is subject to the provisions of RCW 48.49.030 and 48.49.040.(3)(a) Except to the extent provided in (b) of this subsection, the carrier must hold an enrollee harmless from balance billing when emergency services described in subsection (1)(a) of this section are provided by an out-of-network hospital in a state that borders Washington state.(b)(i) Upon the effective date of federal legislation prohibiting balance billing when emergency services described in subsection (1)(a) of this section are provided by a hospital, the carrier no longer has a duty to hold enrollees harmless from balance billing under (a) of this subsection; or(ii) Upon the effective date of an interstate compact with a state bordering Washington state or enactment of legislation by a state bordering Washington state prohibiting balance billing when emergency services described in subsection (1)(a) of this section are provided by a hospital located in that border state to a Washington state resident, the carrier no longer has a duty to hold enrollees harmless from balance billing under (a) of this subsection for services provided by a hospital in that border state. The commissioner shall engage with border states on appropriate means to prohibit balance billing by out-of-state hospitals of Washington state residents.(4) This section applies to health care providers or facilities providing services to members of entities administering a self-funded group health plan and its plan members only if the entity has elected to participate in this section and RCW 48.49.030 and 48.49.040 as provided in RCW 48.49.130.[ 2019 c 427 § 6.]
WA Rev Code § 48.49.050 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.050 - Commissioner's annual report on dispute resolution information regarding arbitration over commercially reasonable payment amounts.

RCW 48.49.050 Commissioner's annual report on dispute resolution information regarding arbitration over commercially reasonable payment amounts. (Expires January 1, 2024.)(1) The commissioner must prepare an annual report summarizing the dispute resolution information provided by arbitrators under RCW 48.49.040. The report must include summary information related to the matters decided through arbitration, as well as the following information for each dispute resolved through arbitration: The name of the carrier; the name of the health care provider; the health care provider's employer or the business entity in which the provider has an ownership interest; the health care facility where the services were provided; and the type of health care services at issue.(2) The commissioner must post the report on the office of the insurance commissioner's website and submit the report in compliance with RCW 43.01.036 to the appropriate committees of the legislature, annually by July 1st.(3) This section expires January 1, 2024.[ 2019 c 427 § 9.]
WA Rev Code § 48.49.060 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.060 - Notice of consumer rights concerning balance billing protection—Development of standard template language by commissioner.

RCW 48.49.060 Notice of consumer rights concerning balance billing protection—Development of standard template language by commissioner.(1) The commissioner, in consultation with health carriers, health care providers, health care facilities, and consumers, must develop standard template language for a notice of consumer rights notifying consumers that:(a) The prohibition against balance billing in this chapter is applicable to health plans issued by carriers in Washington state and self-funded group health plans that elect to participate in RCW 48.49.020 through 48.49.040 as provided in RCW 48.49.130;(b) They cannot be balance billed for the health care services described in RCW 48.49.020 and will receive the protections provided by RCW 48.49.030; and(c) They may be balance billed for health care services under circumstances other than those described in RCW 48.49.020 or if they are enrolled in a health plan to which chapter 427, Laws of 2019 does not apply, and steps they can take if they are balance billed.(2) The standard template language must include contact information for the office of the insurance commissioner so that consumers may contact the office of the insurance commissioner if they believe they have received a balance bill in violation of this chapter.(3) The office of the insurance commissioner shall determine by rule when and in what format health carriers, health care providers, and health care facilities must provide consumers with the notice developed under this section.[ 2019 c 427 § 10.]
WA Rev Code § 48.49.070 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.070 - Hospital or ambulatory surgical facility—Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists.

RCW 48.49.070 Hospital or ambulatory surgical facility—Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists.(1)(a) A hospital or ambulatory surgical facility must post the following information on its website, if one is available:(i) The listing of the carrier health plan provider networks with which the hospital or ambulatory surgical facility is an in-network provider, based upon the information provided by the carrier pursuant to RCW 48.43.730(7); and(ii) The notice of consumer rights developed under RCW 48.49.060.(b) If the hospital or ambulatory surgical facility does not maintain a website, this information must be provided to consumers upon an oral or written request.(2) Posting or otherwise providing the information required in this section does not relieve a hospital or ambulatory surgical facility of its obligation to comply with the provisions of this chapter.(3) Not less than thirty days prior to executing a contract with a carrier, a hospital or ambulatory surgical facility must provide the carrier with a list of the nonemployed providers or provider groups contracted to provide surgical or ancillary services at the hospital or ambulatory surgical facility. The hospital or ambulatory surgical facility must notify the carrier within thirty days of a removal from or addition to the nonemployed provider list. A hospital or ambulatory surgical facility also must provide an updated list of these providers within fourteen calendar days of a request for an updated list by a carrier.[ 2019 c 427 § 11.]
WA Rev Code § 48.49.080 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.080 - Health care provider—Requirement to provide certain information on website or upon consumer request—Requirement to submit network status information to carriers.

RCW 48.49.080 Health care provider—Requirement to provide certain information on website or upon consumer request—Requirement to submit network status information to carriers.(1)(a) A health care provider must provide the following information on its website, if one is available:(i) The listing of the carrier health plan provider networks with which the provider contracts, based upon the information provided by the carrier pursuant to RCW 48.43.730(7); and(ii) The notice of consumer rights developed under RCW 48.49.060.(b) If the health care provider does not maintain a website, this information must be provided to consumers upon an oral or written request.(2) Posting or otherwise providing the information required in this section does not relieve a provider of its obligation to comply with the provisions of this chapter.(3) An in-network provider must submit accurate information to a carrier regarding the provider's network status in a timely manner, consistent with the terms of the contract between the provider and the carrier.[ 2019 c 427 § 12.]
WA Rev Code § 48.49.090 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.090 - Carrier—Requirement to update website and provider directory—Requirement to provide enrollee with certain information.

RCW 48.49.090 Carrier—Requirement to update website and provider directory—Requirement to provide enrollee with certain information.(1) A carrier must update its website and provider directory no later than thirty days after the addition or termination of a facility or provider.(2) A carrier must provide an enrollee with:(a) A clear description of the health plan's out-of-network health benefits; and(b) The notice of consumer rights developed under RCW 48.49.060;(c) Notification that if the enrollee receives services from an out-of-network provider or facility, under circumstances other than those described in RCW 48.49.020, the enrollee will have the financial responsibility applicable to services provided outside the health plan's network in excess of applicable cost-sharing amounts and that the enrollee may be responsible for any costs in excess of those allowed by the health plan;(d) Information on how to use the carrier's member transparency tools under RCW 48.43.007;(e) Upon request, information regarding whether a health care provider is in-network or out-of-network, and whether there are in-network providers available to provide surgical or ancillary services at specified in-network hospitals or ambulatory surgical facilities; and(f) Upon request, an estimated range of the out-of-pocket costs for an out-of-network benefit.[ 2019 c 427 § 13.]
WA Rev Code § 48.49.100 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.100 - Pattern of unresolved violations—Enforcement action by department of health or appropriate disciplining authority.

RCW 48.49.100 Pattern of unresolved violations—Enforcement action by department of health or appropriate disciplining authority.(1) If the commissioner has cause to believe that any health care provider, hospital, or ambulatory surgical facility, has engaged in a pattern of unresolved violations of RCW 48.49.020 or 48.49.030, the commissioner may submit information to the department of health or the appropriate disciplining authority for action. Prior to submitting information to the department of health or the appropriate disciplining authority, the commissioner may provide the health care provider, hospital, or ambulatory surgical facility, with an opportunity to cure the alleged violations or explain why the actions in question did not violate RCW 48.49.020 or 48.49.030.(2) If any health care provider, hospital, or ambulatory surgical facility, has engaged in a pattern of unresolved violations of RCW 48.49.020 or 48.49.030, the department of health or the appropriate disciplining authority may levy a fine or cost recovery upon the health care provider, hospital, or ambulatory surgical facility in an amount not to exceed the applicable statutory amount per violation and take other action as permitted under the authority of the department or disciplining authority. Upon completion of its review of any potential violation submitted by the commissioner or initiated directly by an enrollee, the department of health or the disciplining authority shall notify the commissioner of the results of the review, including whether the violation was substantiated and any enforcement action taken as a result of a finding of a substantiated violation.(3) If a carrier has engaged in a pattern of unresolved violations of any provision of this chapter, the commissioner may levy a fine or apply remedies authorized under chapter 48.02 RCW, RCW 48.44.166, 48.46.135, or 48.05.185.(4) For purposes of this section, "disciplining authority" means the agency, board, or commission having the authority to take disciplinary action against a holder of, or applicant for, a professional or business license upon a finding of a violation of chapter 18.130 RCW or a chapter specified under RCW 18.130.040.[ 2019 c 427 § 14.]
WA Rev Code § 48.49.110 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.110 - Rule-making authority.

RCW 48.49.110 Rule-making authority.The commissioner may adopt rules to implement and administer this chapter, including rules governing the dispute resolution process established in RCW 48.49.040.[ 2019 c 427 § 15.]
WA Rev Code § 48.49.120 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.120 - No application of chapter to health plans under chapter 74.09 RCW.

RCW 48.49.120 No application of chapter to health plans under chapter 74.09 RCW.This chapter does not apply to health plans that provide benefits under chapter 74.09 RCW.[ 2019 c 427 § 22.]
WA Rev Code § 48.49.130 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.130 - Application of chapter to self-funded group health plans that elect to participate in balance billing protection provisions—Annual notice to commissioner.

RCW 48.49.130 Application of chapter to self-funded group health plans that elect to participate in balance billing protection provisions—Annual notice to commissioner.The provisions of this chapter apply to a self-funded group health plan governed by the provisions of the federal employee retirement income security act of 1974 (29 U.S.C. Sec. 1001 et seq.) only if the self-funded group health plan elects to participate in the provisions of RCW 48.49.020 through 48.49.040. To elect to participate in these provisions, the self-funded group health plan shall provide notice, on an annual basis, to the commissioner in a manner prescribed by the commissioner, attesting to the plan's participation and agreeing to be bound by RCW 48.49.020 through 48.49.040. An entity administering a self-funded health benefits plan that elects to participate under this section, shall comply with the provisions of RCW 48.49.020 through 48.49.040.[ 2019 c 427 § 23.]
WA Rev Code § 48.49.140 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.140 - Liberal construction of chapter to promote public interest.

RCW 48.49.140 Liberal construction of chapter to promote public interest.This chapter must be liberally construed to promote the public interest by ensuring that consumers are not billed out-of-network charges and do not receive additional bills from providers under the circumstances described in RCW 48.49.020.[ 2019 c 427 § 24.]
WA Rev Code § 48.49.150 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.150 - Determining the adequacy of provider networks—Required considerations.

RCW 48.49.150 Determining the adequacy of provider networks—Required considerations.When determining the adequacy of a proposed provider network or the ongoing adequacy of an in-force provider network, the commissioner must consider whether the carrier's proposed provider network or in-force provider network includes a sufficient number of contracted providers of emergency and surgical or ancillary services at or for the carrier's contracted in-network hospitals or ambulatory surgical facilities to reasonably ensure enrollees have in-network access to covered benefits delivered at that facility.[ 2019 c 427 § 25.]
WA Rev Code § 48.49.900 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.49 - Balance Billing Protection Act.|48.49.900 - Effective date—2019 c 427.

RCW 48.49.900 Effective date—2019 c 427.Except for section 26 of this act, this act takes effect January 1, 2020.[ 2019 c 427 § 31.]
WA Rev Code § 48.50.010 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.50 - Insurance Fraud Reporting Immunity Act.|48.50.010 - Short title.

RCW 48.50.010 Short title.This chapter shall be known and may be cited as the Insurance Fraud Reporting Immunity Act.[ 1995 c 285 § 20; 1979 ex.s. c 80 § 1.]NOTES:Effective date—1995 c 285: See RCW 48.30A.900.
WA Rev Code § 48.50.020 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.50 - Insurance Fraud Reporting Immunity Act.|48.50.020 - Definitions.

RCW 48.50.020 Definitions.As used in this chapter the following terms have the meanings indicated unless the context clearly requires otherwise.(1) "Authorized agency" means a public agency or its official representative having legal authority to investigate criminal activity or the cause of a fire or to initiate criminal proceedings, including the following persons and agencies:(a) The chief of the Washington state patrol and the director of fire protection;(b) The prosecuting attorney of the county where the criminal activity occurred;(c) State, county, and local law enforcement agencies;(d) The state attorney general;(e) The federal bureau of investigation, or any other federal law enforcement agency;(f) The United States attorney's office; and(g) The office of the insurance commissioner.(2) "Insurer" means any insurer, as defined in RCW 48.01.050 and any self-insurer.(3) "Relevant information" means information having any tendency to make the existence of any fact that is of consequence to the investigation or determination of criminal activity or the cause of any fire more probable or less probable than it would be without the information.[ 2000 c 254 § 1. Prior: 1995 c 369 § 36; 1995 c 285 § 21; 1986 c 266 § 77; 1985 c 470 § 27; 1979 ex.s. c 80 § 2.]NOTES:Effective date—1995 c 369: See note following RCW 43.43.930.Effective date—1995 c 285: See RCW 48.30A.900.Severability—1986 c 266: See note following RCW 38.52.005.Severability—Effective date—1985 c 470: See notes following RCW 43.44.010.
WA Rev Code § 48.50.030 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.50 - Insurance Fraud Reporting Immunity Act.|48.50.030 - Release of information or evidence by insurer.

RCW 48.50.030 Release of information or evidence by insurer.(1) Any authorized agency may request, in writing, that an insurer release to the agency any or all relevant information or evidence which the insurer may have in its possession relating to criminal activity, if such information or evidence is deemed important by the agency in its discretion.(2) An insurer who has reason to believe that a person participated or is participating in criminal activity relating to a contract of insurance may report relevant information to an authorized agency.(3) The information provided to an authorized agency under this section may include, without limitation:(a) Pertinent insurance policy information relating to a claim under investigation and any application for such a policy;(b) Policy premium payment records which are available;(c) History of previous claims in which the person was involved; and(d) Material relating to the investigation of the loss, including statements of any person, proof of loss, and any other evidence found in the investigation.(4) The insurer receiving a request under subsection (1) of this section shall furnish all relevant information requested to the agency within a reasonable time, orally or in writing.[ 1995 c 285 § 22; 1979 ex.s. c 80 § 3.]NOTES:Effective date—1995 c 285: See RCW 48.30A.900.
WA Rev Code § 48.50.040 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.50 - Insurance Fraud Reporting Immunity Act.|48.50.040 - Notification by insurer.

RCW 48.50.040 Notification by insurer.(1) When an insurer has reason to believe that a fire loss reported to the insurer may be of other than accidental cause, the insurer shall notify the chief of the Washington state patrol, through the director of fire protection, in the manner prescribed under RCW 48.05.320 concerning the circumstances of the fire loss, including any and all relevant material developed from the insurer's inquiry into the fire loss.(2) Notification of the chief of the Washington state patrol, through the director of fire protection, under subsection (1) of this section does not relieve the insurer of the duty to respond to a request for information from any other authorized agency and does not bar an insurer from other reporting under RCW 48.50.030(2).[ 2000 c 254 § 2. Prior: 1995 c 369 § 37; 1995 c 285 § 23; 1986 c 266 § 91; 1979 ex.s. c 80 § 4.]NOTES:Effective date—1995 c 369: See note following RCW 43.43.930.Effective date—1995 c 285: See RCW 48.30A.900.Severability—1986 c 266: See note following RCW 38.52.005.
WA Rev Code § 48.50.050 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.50 - Insurance Fraud Reporting Immunity Act.|48.50.050 - Release of information by authorized agencies.

RCW 48.50.050 Release of information by authorized agencies.An authorized agency receiving information under RCW 48.50.030, 48.50.040, or 48.50.055 may release or provide such information to any other authorized agencies.[ 2000 c 254 § 3; 1979 ex.s. c 80 § 5.]