reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › SUBSTANTIVE RULES › Section 246-25-010 - Definitions

Current through Register Vol. 24-14, July 15, 2024
Unless the context requires otherwise, the definitions
					 contained in this section apply throughout this chapter.
(1)
"Attorney general"
means the
				  antitrust section of the office of the attorney general.
(2)
"Applicant"
means a
				  certified health plan, health care facility, health care provider, or other
				  person involved in the development, delivery, or marketing of health services
				  or certified health plans.
(3)
"Parties"
means the natural persons, corporations, or associations
				  involved in the plan or activity which is the subject of the proposal being
				  reviewed.
(4)
"Petition"
means the document that shall be filed with the
				  commission pursuant to
				  RCW
				     43.72.310(3) by an applicant
				  in order to request approval of conduct that could tend to lessen competition
				  in the relevant market.
(5)
"Proposal"
means the plan or activity that is being
				  reviewed.
(6)
"Request for
				  informal opinion"
means the document that may be filed with the
				  commission pursuant to
				  RCW
				     43.72.310(1) by an
				  applicant.
(7)
"Exclusive
				  dealing clause"
means a clause in a contract between a certified health
				  plan and a health care provider or facility by which the provider or facility
				  agree not to provide services to another certified health plan.
(8)
"Health care network"
means
				  a group of providers or facilities controlled by the providers, facilities or
				  intermediary organizations including, but not limited to, physician-hospital
				  organizations and independent practice associations.
(9)
"Most favored nations
				  clause"
means terms in a contract between a certified health plan and a
				  health care provider or facility by which the provider or facility agrees they
				  will not charge other plans a lower price than the price charged the plan
				  instituting the clause.
(10)
"Rural area"
means a geographical area outside the boundaries of
				  Metropolitan Statistical Areas (MSAs) or an area within an MSA, but more than
				  thirty minutes average travel time from an urban area of at least ten thousand
				  population.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-010, filed 1/28/99, effective 1/28/99; 95-04-115, § 245-02-010,
						filed 2/1/95, effective 10/1/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › SUBSTANTIVE RULES › Section 246-25-020 - General policy statement - Antitrust immunity and competitive oversight

Current through Register Vol. 24-14, July 15, 2024
(1) The purpose of
				  WAC 245-02-020 through 245-02-050 is to implement provisions of the act that
				  require the commission to adopt rules governing antitrust immunity, competitive
				  oversight, and conduct of certified health plans, health care providers, and
				  health care facilities. The provisions of these rules shall be strictly
				  construed. Whenever there is doubt as to the meaning of these rules or as to
				  their applicability to particular conduct or circumstances, these rules shall
				  be interpreted in a manner consistent with existing antitrust law principles of
				  this state and of the federal government, including final orders of the Federal
				  Trade Commission and final decisions of the federal courts interpreting the
				  various federal antitrust statutes.
(2) Unless explicitly permitted under this
				  chapter or pursuant to a petition approved in accordance with the provisions of
				  RCW
				     43.72.310(3) and (4),
				  nothing in these rules shall be deemed or interpreted to permit activities or
				  to grant immunity for those activities prohibited under
				  RCW
				     43.72.300(3) or any other
				  activity which would constitute a per se violation of state or federal
				  antitrust laws.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-020, filed 1/28/99, effective 1/28/99; 95-04-115, § 245-02-020,
						filed 2/1/95, effective 10/1/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › SUBSTANTIVE RULES › Section 246-25-025 - Scope and applicability

Current through Register Vol. 24-14, July 15, 2024
The provisions of WAC 245-02-010 through 245-02-050 shall
					 govern contracts and conduct among health care providers, health care
					 facilities, and certified health plans entered into or renewed on and after
					 October 1, 1995.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-025, filed 1/28/99, effective 1/28/99; 95-04-115, § 245-02-025,
						filed 2/1/95, effective 10/1/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › SUBSTANTIVE RULES › Section 246-25-030 - Cooperative activities - Policy statement

Current through Register Vol. 24-14, July 15, 2024
The commission recognizes that reforms in the health system
					 will occur through the development of comprehensive, integrated, and
					 cost-effective health services delivery systems. Because the health services
					 market place is evolving in anticipation of changes required by the act, it
					 would not be appropriate to establish with precision specific areas where
					 cooperative activities are entitled to immunity from antitrust laws. Pursuant
					 to RCW 34.05.023, the commission therefore adopts as an interim policy
					 statement the
Statements of Enforcement Policy and Analytical
					 Principles Relating to Health Care and Antitrust
issued by the U.S.
					 Department of Justice and the Federal Trade Commission on September 27, 1994.
					 These nine policy statements address: (1) Mergers among hospitals; (2) hospital
					 joint ventures involving high-technology or other expensive health care
					 equipment; (3) hospital joint ventures involving specialized clinical or other
					 expensive health care services; (4) providers' collective provision of
					 nonfee-related information to purchasers of health care services; (5)
					 providers' collective provision of fee-related information to purchasers of
					 health care services; (6) provider participation in exchanges of price and cost
					 information; (7) joint purchasing arrangements among health care providers; (8)
					 physician network joint ventures; and (9) analytical principles relating to
					 multiprovider networks.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-030, filed 1/28/99, effective 1/28/99; 95-04-115, § 245-02-030,
						filed 2/1/95, effective 10/1/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › SUBSTANTIVE RULES › Section 246-25-035 - Consumer access to local health services in rural areas

Current through Register Vol. 24-14, July 15, 2024
An applicant may petition the commission for approval of a
					 managed health care finance and delivery system in a rural area that may
					 violate existing antitrust law principles or provisions of WAC 245-02-040,
					 245-02-045 or 245-02-050 but is necessary to preserve local access to regular
					 and ongoing health services in a rural area. In addition to the requirements
					 set forth in WAC 245-02-110, et seq., such petitions shall include information
					 demonstrating that the proposed system: (a) Has been developed through a
					 community-based process that takes into consideration the concerns of local
					 residents, health care providers, public and private health care facilities,
					 local community organizations, and appropriate state agency health planning
					 organizations located in or with responsibility for health services in rural
					 areas, (b) will achieve quality improvements and cost efficiencies over present
					 health service capabilities in the rural area, (c) will result in local access
					 to regular and ongoing services required under the uniform benefits package,
					 (d) will combine health care service delivery and financing, and (e) will or
					 will not have special community governance arrangements. Nothing contained in
					 this section shall be deemed to relieve an applicant from meeting the
					 requirements imposed by law for registration and certification of certified
					 health plans.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-035, filed 1/28/99, effective 1/28/99; 95-04-115, § 245-02-035,
						filed 2/1/95, effective 10/1/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › SUBSTANTIVE RULES › Section 246-25-040 - Collective negotiations - Policy statement - Permitted negotiations - Petitions

Current through Register Vol. 24-14, July 15, 2024
(1)
				  The board finds that collective negotiation by competing health care providers
				  of certain nonfee terms and conditions of contracts with health carriers may
				  result in procompetitive effects in the absence of any express or implied
				  threat of retaliatory collective action by health care providers. However, the
				  board finds few or no procompetitive effects in permitting competing health
				  care providers to collectively negotiate contract terms and conditions that
				  include fees or prices for provider services. The potential anticompetitive
				  harms arising from collective exchanges of fee or price information by
				  competing providers and collective negotiation by competing providers of the
				  fees to be paid providers by health carriers far outweigh any potential gains
				  in simplifying provider and health carrier negotiations, any reduction in
				  transaction costs, and any potential gains in cost-effective health care
				  delivery systems. To the contrary, the board finds that collective negotiation
				  of fees or other prices for services by competing health care providers creates
				  the potential to thwart the cost containment goals of health care reform by
				  enabling health care providers to resist health carrier and purchaser pressure
				  to reduce or limit the increase in prices for health care services. Except as
				  herein provided, nothing contained in this section shall authorize any person
				  or entity to engage in activities that would constitute violations of state or
				  federal antitrust laws.
(2)
				  Competing health care providers within the service area of a health carrier may
				  meet and communicate for the purposes of collectively negotiating the following
				  terms and conditions of contracts with health carriers:
(a) Respective provider and health carrier
				  liability for the treatment or lack of treatment of health carrier
				  enrollees;
(b) Administrative
				  procedures including methods and timing of provider payment for
				  services;
(c) Dispute resolution
				  procedures relating to disputes between health carriers and providers including
				  disputes between providers and health carriers that originate from
				  enrollees;
(d) Patient referral
				  procedures;
(e) Formulation and
				  application of reimbursement methodology, e.g., risk pools, capitation, and
				  capitation between providers and hospitals, except as provided in section
				  3;
(f) Quality assurance
				  programs;
(g) Health service
				  utilization review procedures; and
(h) Carrier provider selection and
				  termination criteria, or whether to engage in selective contracting.
Nothing herein shall be construed to allow a
					 boycott.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › SUBSTANTIVE RULES › Section 246-25-045 - "Most favored nations clauses" - Policy statement

Current through Register Vol. 24-14, July 15, 2024
"Most favored nations clauses" may discourage discounting
					 by the affected seller, may facilitate oligopolistic pricing and deter entry by
					 more efficient competitors. "Most favored nations clauses" are often used as a
					 replacement for innovation or efficiency by large competitors and act as a
					 disincentive for creativity by small competitors. The commission finds that the
					 use of "most favored nations clauses" in contracts between a health care
					 provider or facility and a certified health plan create the potential to thwart
					 the cost containment goals of health care reform. For these reasons, the use of
					 "most favored nations clauses" in contracts between a health care provider or
					 facility and a certified health plan is prohibited.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-045, filed 1/28/99, effective 1/28/99; 95-04-115, § 245-02-045,
						filed 2/1/95, effective 10/1/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › SUBSTANTIVE RULES › Section 246-25-050 - Exclusive dealing clauses - Policy statement

Current through Register Vol. 24-14, July 15, 2024
(1) Exclusive dealing clauses in health care
				  provider and facility contracts with certified health plans may enhance the
				  quality of health services, achieve economic efficiencies, or improve the
				  cost-effective use of health services and equipment. Exclusive dealing clauses
				  may also reduce competition among certified health plans, providers, and
				  facilities when the clauses prevent other competitors from entering the
				  relevant market, thereby increasing the probability of the creation of a
				  monopoly in that market.
(2) A
				  contract between a certified health plan and a health care facility or provider
				  may not contain an exclusive dealing clause if the plan holds more than forty
				  percent of the relevant market.
(3)
				  A contract between a certified health plan and a health care facility or
				  provider may contain an exclusive dealing clause if the plan holds twenty
				  percent or less of the relevant market.
(4) A contract between a certified health
				  plan and a health care facility or provider may contain an exclusive dealing
				  clause if the plan holds between twenty and forty percent of the relevant
				  market and the commission has explicitly permitted its use. To obtain such
				  approval, a plan must request an informal opinion as to use of the clause in
				  the particular circumstances or seek approval by written petition pursuant to
				  the procedures set forth in WAC 245-02-110, et seq.
(5) A contract between a health care network
				  and a health care facility or provider may not contain an exclusive dealing
				  clause if the health care network holds more than forty percent of the relevant
				  market.
(6) A contract between a
				  health care network and a health care facility or provider may contain an
				  exclusive dealing clause if the health care network holds twenty percent or
				  less of the relevant market.
(7) A
				  contract between a health care network and a health care facility or provider
				  may contain an exclusive dealing clause if the network holds between twenty and
				  forty percent of the relevant market and the commission has explicitly
				  permitted its use. To obtain such approval, a network must request an informal
				  opinion as to use of the clause in the particular circumstances or seek
				  approval by written petition pursuant to the procedures set forth in WAC
				  245-02-110, et seq.
(8) The
				  provisions of this section do not apply to contracts between a staff or group
				  model health maintenance organization and its health care facilities or
				  providers.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-050, filed 1/28/99, effective 1/28/99; 95-04-115, § 245-02-050,
						filed 2/1/95, effective 10/1/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-100 - Purpose

Current through Register Vol. 24-14, July 15, 2024
The purpose of WAC 245-02-110 through 245-02-175 is to
					 implement RCW    43.72.310 by setting forth the
					 form and procedure for: (1) Requests for informal opinions from the attorney
					 general as to whether particular conduct is authorized by the act, and (2)
					 written petitions to the commission requesting approval of conduct that could
					 tend to lessen competition in a relevant market.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-100, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-100,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-110 - Form of petition and request for informal opinion

Current through Register Vol. 24-14, July 15, 2024
A petition, request for informal opinion, or request for
					 adjudicatory proceeding shall adhere generally to the following form:
(1) At the top of the page shall appear the
				  wording "before the Washington Health Services Commission." On the left side of
				  the page, below the foregoing, the following caption shall be set out "In the
				  Matter of (name of applicant)." Opposite the foregoing caption shall appear the
				  words "petition," or "request for informal opinion," or, "request for
				  adjudicatory proceeding," whichever is applicable.
(2) The materials required by WAC 245-02-115
				  through 245-02-125 shall be attached to the foregoing.
(3) The petition or request shall be signed
				  and dated by the entity named in the first paragraph, or by its attorney. The
				  original and five copies shall be filed with the commission as described in WAC
				  245-02-130.
(4) Information
				  required by this chapter may be submitted in hard copy or in machine readable
				  form:
(a) If hard copy, documents shall be
				  submitted and organized by request;
(b) If in machine readable form, the data
				  should comply with specifications acceptable to the commission and attorney
				  general, which will be provided upon request.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-115 - Contents of requests for informal opinions and written petitions

Current through Register Vol. 24-14, July 15, 2024
The following information shall accompany any written
					 petition or request for informal opinion submitted to the commission:
(1)
Identification of parties.
Identify all parties to the proposal, and their parent entities, and for each
				  one state:
(a) The name(s) under which it is
				  doing business, or proposes to do business, in Washington;
(b) Its business address(es);
(c) Its type of business organization (for
				  example, corporation, sole proprietorship, partnership, or
				  association);
(d) A brief
				  description of the nature or type of business conducted at each of its business
				  locations within the state of Washington; and
(e) The person to whom questions regarding
				  the request or petition should be directed.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-120 - Continuing oversight and reporting requirements

Current through Register Vol. 24-14, July 15, 2024
Written petitions and requests for informal opinions must
					 include, in narrative form, a description of the nature of the continued
					 supervision and oversight the parties' believe would be necessary and
					 appropriate to ensure the proposal continues to be consistent with the petition
					 or request and that its benefits continue to outweigh its disadvantages. The
					 description shall include a recommendation for the form of annual or more
					 frequent progress reports appropriate to the transaction and sufficient to
					 allow the commission and attorney general to evaluate the continuing
					 conduct.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-120, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-120,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-130 - Submission of information

Current through Register Vol. 24-14, July 15, 2024
(1)
				  The applicant requesting an informal opinion or submitting a written petition
				  shall direct the request or written petition to the Chair of the Commission at
				  the Washington Health Services Commission, P.O. Box 41185, Olympia, Washington
				  98504-1185. Upon receipt of an informal opinion request or written petition,
				  the commission will send a copy of the request or written petition to the
				  Office of the Attorney General, Antitrust Section, 900 Fourth Avenue, Suite
				  2000, Seattle, Washington 98164-1012.
(2) The applicant shall also send a copy of
				  the petition and request for informal opinion to any organization representing
				  employees of the applicant.
(3)
				  Each petition and request for informal opinion shall contain a certificate from
				  each person submitting information stating that the information submitted is
				  true and accurate to the best of that person's knowledge.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-130, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-130,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-131 - Public notice and comment

Current through Register Vol. 24-14, July 15, 2024
(1) The commission may solicit comments from
				  the public on the petition, request for informal opinion or request for
				  adjudicatory proceeding by causing notice to be published in the state register
				  of the subject matter of a petition, request for informal opinion or request
				  for adjudicatory proceeding, and indicating how, when and where persons may
				  comment.
(2) No later than three
				  days after its publication in the state register, the commission shall cause a
				  copy of the notice of a petition, request for informal opinion or request for
				  adjudicatory proceeding to be mailed to each person who has made a request to
				  the agency for a mailed copy of such notice. The commission will charge for the
				  actual cost of providing individual mailed copies of these notices.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-131, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-131,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-135 - Commission to provide copy of informal opinion to applicant

Current through Register Vol. 24-14, July 15, 2024
(1) Within five
				  days of receipt of an attorney general's informal opinion requested by the
				  commission under
				  RCW
				     43.72.310(1), the commission
				  shall mail a copy of the informal opinion to the requesting applicant. The
				  applicant shall provide a copy of the informal opinion to the employee
				  organizations representing the applicant's employees.
(2) No later than three days after its
				  mailing of a copy of the informal opinion to the requesting party, the
				  commission shall cause a copy of the attorney general's informal opinion to be
				  mailed to each person who has made a request to the agency for a mailed copy.
				  The commission may charge for the actual cost of providing individual mailed
				  copies of these informal opinions.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-135, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-135,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-140 - Attorney general to provide informal opinion and advice on petitions to the commission

Current through Register Vol. 24-14, July 15, 2024
As required by
					 RCW
					    43.72.310(1), the attorney
					 general will respond to a request for an informal opinion, or for advice
					 regarding a written petition. The attorney general shall have discretion over
					 the scope of the informal opinion or advice provided.
(1) An informal opinion rendered by the
				  attorney general pursuant to
				  RCW
				     43.72.310(1) will include
				  the following:
(a) A statement of the facts
				  relied upon in the opinion;
(b) A
				  statement of the issues presented by the applicant;
(c) The attorney general's analysis;
				  and
(d) The attorney general's
				  conclusion as to whether the proposed conduct is authorized by chapter 43.72
				  RCW.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-145 - Applicant may request an adjudicative proceeding or file a petition

Current through Register Vol. 24-14, July 15, 2024
An applicant may request an adjudicative proceeding in the
					 following circumstances:
(1) Where the
				  applicant has received an informal opinion pursuant to
				  RCW
				     43.72.310 and within thirty days of the
				  applicant's receipt of the opinion, the applicant requests an adjudicatory
				  proceeding to determine whether the proposed conduct should be authorized
				  pursuant to
				  RCW
				     43.72.310(2)(a) because it
				  is likely to achieve the policy goals of chapter 43.72 RCW and a more
				  competitive alternative is impractical;
(2) If the attorney general concludes in its
				  informal opinion that the conduct proposed is not authorized by chapter 43.72
				  RCW, the requesting applicant shall have thirty days from the date of receipt
				  of the informal opinion from the commission to file a written petition with the
				  commission requesting approval of conduct that could tend to lessen competition
				  in the relevant market pursuant to
				  RCW
				     43.72.310(3). The petition
				  shall constitute an application for an adjudicatory proceeding under
				  RCW
				     34.05.413; or
(3) Pursuant to
				  RCW
				     43.72.310(3) an applicant
				  may file a written petition with the commission requesting approval of conduct
				  that could tend to lessen competition in the relevant market regardless of
				  whether it has previously sought an informal opinion. The petition shall
				  constitute an application for an adjudicatory proceeding under
				  RCW
				     34.05.413.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-145, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-145,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-150 - Decision not to conduct an adjudication

Current through Register Vol. 24-14, July 15, 2024
If the commission decides not to conduct an adjudicative
					 proceeding in response to an application, the commission shall furnish the
					 applicant a copy of its decision in writing, with a brief statement of the
					 commission's reasons and of any administrative review available to the
					 applicant.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-150, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-150,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-155 - Adjudicative proceeding - Rules of procedure

Current through Register Vol. 24-14, July 15, 2024
An application for an adjudicative proceeding shall be
					 accompanied by all of the information required for requests for informal
					 opinions and written petitions, as described in WAC 245-02-115 to 245-02-125.
					 The applicant may incorporate by reference any materials previously provided to
					 the commission or attorney general. Except as set forth in WAC 245-02-160
					 through 245-02-175, the commission adopts for its use the Model Rules of
					 Procedure set forth in chapter 10-08 WAC.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-155, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-155,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-160 - Adjudicative proceedings - Notice of hearing

Current through Register Vol. 24-14, July 15, 2024
(1) Within thirty days of receipt of an
				  application for adjudicative proceeding or petition, the commission shall
				  notify the applicant of any obvious errors or omissions, request any additional
				  information it requires and is permitted by law to require regarding the
				  application for adjudicative proceeding or petition, and notify the applicant
				  of the name, mailing address, and telephone number that may be contacted
				  regarding the application.
(2)
				  Within sixty days after receipt of the application, the commission shall
				  commence an adjudicative proceeding by serving notice of hearing on the
				  applicant and all other persons required by
				  RCW
				     34.05.434; 34.05.417 (1)(b), or decide not to
				  conduct an adjudicative proceeding and furnish the applicant with a copy of its
				  decision in writing, with a brief statement of its reasons for doing so and of
				  any administrative review available.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-160, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-160,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-165 - Presiding officer

Current through Register Vol. 24-14, July 15, 2024
The determination of the presiding officer for an
					 adjudicative proceeding before the commission shall be governed by
					 RCW
					    34.05.425.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-165, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-165,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-170 - Commission to retain jurisdiction

Current through Register Vol. 24-14, July 15, 2024
A grant or denial of authority to engage in proposed
					 conduct shall be deemed a final order of the commission. Where authorization is
					 granted, the commission shall retain jurisdiction over the applicant for
					 purposes of continuing oversight and supervision as required by
					 RCW
					    43.72.310(6).
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-170, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-170,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-175 - Adjudicative proceedings - Reconsideration

Current through Register Vol. 24-14, July 15, 2024
A petition for reconsideration of a final order under
					 RCW
					    34.05.470 shall be filed with the
					 commission.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-175, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-175,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-25 - Antitrust immunity and competitive oversight › PROCEDURAL RULES › Section 246-25-180 - Notice of modification or withdrawal of authorization

Current through Register Vol. 24-14, July 15, 2024
If at anytime during its ongoing supervision of authorized
					 conduct pursuant to
					 RCW
					    43.72.310(6), the commission
					 determines that reason exists to revoke or modify its authorization, the
					 commission shall immediately notify the applicant in writing. An applicant may
					 request an adjudicative proceeding within thirty days of receipt of the notice.
					 If no adjudicative hearing is requested by the applicant within thirty days of
					 receipt of the notice, the commission shall immediately revoke or modify its
					 authorization.
Statutory Authority:
						RCW
						43.72.310. 99-04-049, recodified as §
						246-25-180, filed 1/28/99, effective 1/28/99; 95-04-112, § 245-02-180,
						filed 2/1/95, effective 3/4/95.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-001 - Purpose

Current through Register Vol. 24-14, July 15, 2024
The purpose of A coordinated quality improvement program is
				  to improve the quality of health care services and identify and prevent medical
				  malpractice under
				  RCW
				     43.70.510. This chapter establishes the
				  criteria and approval process for health care entities who choose to apply for
				  a department of health -approved coordinated quality improvement program under
				  RCW
				     43.70.510. A coordinated quality improvement
				  pro-gram plan must be approved by the department before the discovery
				  limitations provided in
				  RCW
				     43.70.510(3) and (4)    and the
				  exemptions under
				  RCW
				     42.56.360(1)(c) and
				  43.70.510(5) shall apply.
Statutory Authority:
					 RCW
					    43.70.510,
					 70.41.200,
					 4.24.250. 06-03-123, §
					 246-50-001, filed 1/18/06, effective 2/18/06. Statutory Authority:
					 RCW
					    43.70.510. 96-09-042, § 246-50-001,
					 filed 4/11/96, effective 5/12/96; 94-24-001, § 246-50-001, filed 11/23/94,
					 effective 12/24/94.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-005 - Applicant eligibility

Current through Register Vol. 24-14, July 15, 2024
(1)
				The following health care entities may apply for the coordinated quality
				improvement program:
(a) Health care
				institutions and medical facilities other than hospitals, that are licensed by
				the department;
(b) Professional
				societies or organizations;
(c)
				Health care service contractors as defined in
				RCW
				   48.44.010;
(d) Health maintenance organizations as
				defined in
				RCW
				   48.46.020;
(e) Health carriers approved pursuant to
				chapter 48.43 RCW;
(f) Any other
				person or entity providing health care coverage under chapter 48.42 RCW that is
				subject to the jurisdiction and regulation of any state or any subdivision
				thereof; and
(g) Health care
				provider groups of five or more providers.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-010 - Definitions

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply throughout this chapter
				  unless the context clearly requires otherwise.
(1) "Alternative program" means a coordinated
				quality improvement program determined by the department to be substantially
				equivalent to
				RCW
				   70.41.200(1).
(2) "Department" means the Washington state
				department of health.
(3)
				"Governing body" means:
(a) The person,
				persons, or board responsible for the health care entity; or
(b) In the case of a provider group where no
				person, persons, or board is in charge of all providers, the person, persons,
				or group identified by the provider group is responsible for the coordinated
				quality improvement program.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-020 - Coordinated quality improvement program-Components

Current through Register Vol. 24-14, July 15, 2024
A program under the provisions of
				  RCW
				     43.70.510 shall include, at a minimum:
(1) The following components, as modified and
				approved by the department to reflect the structural organization of the health
				care entity:
(a) A governing body;
(b) A committee, appointed by the governing
				body, with a broad representation of the services offered, responsible for:
(i) Reviewing services rendered, both
				retrospectively and prospectively, to improve the quality of health care by
				measuring key characteristics such as effectiveness, accuracy, timeliness, and
				cost;
(ii) Reviewing categories and
				methodologies of services rendered and to be rendered with the goal of
				improving health care outcomes;
(iii) Overseeing and coordinating the
				program;
(iv) Ensuring information
				gathered for the program is reviewed and used to revise health care policies
				and procedures; and
(v) Reporting
				to the governing body, at least semiannually, on program activities and actions
				taken as a result of those activities;
(c) Periodic evaluation of each provider
				under the purview of the program, including mental and physical capacity,
				competence in delivering health care, and verification of current
				credentials;
(d) A procedure for
				promptly resolving all complaints pertaining to accidents, injuries, treatment
				and other events that may result in claims of health care
				malpractice;
(e) A method for
				continually collecting and maintaining information concerning:
(i) Experience with negative health care
				outcomes and injurious incidents; and
(ii) Professional liability premiums,
				settlements, awards, costs for injury prevention and safety improvement
				activities;
(f) A method
				for maintaining information gathered under the purview of the program
				concerning a provider in that provider's personnel or credential file, assuring
				patient confidentiality;
(g) A
				process for reporting accidents, injuries, negative health outcomes, and other
				pertinent information to the quality improvement committee;
(h) A process assuring compliance with
				reporting requirements to appropriate local, state, and federal
				authorities;
(i) A method for
				identifying documents and records created specifically for and collected and
				maintained by the quality improvement committee;
(j) Educational activities for personnel
				engaged in health care activities including, but not limited to:
(i) Quality improvement;
(ii) Safety and injury prevention;
(iii) Responsibilities for reporting
				professional misconduct;
(iv) Legal
				aspects of providing health care;
(v) Improving communication with health care
				recipients; and
(vi) Causes of
				malpractice claims; or
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-030 - Application approval and renewal process

Current through Register Vol. 24-14, July 15, 2024
(1) To obtain department approval of a
				program, an authorized representative of the health care entity shall submit to
				the department a completed application on forms provided by the department. A
				completed application must include at least the following:
(a) A table of contents clearly denoting, at
				a minimum, where each component specified in WAC
				246-50-020
				is located within the program plan;
(b) A program plan with detailed description
				of every aspect of the program including every component of the program
				required under WAC
				246-50-020;
(c) The fee specified in WAC
				246-50-990; and
(d) Other information as may be required by
				the department.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-035 - Modification of an approved plan

Current through Register Vol. 24-14, July 15, 2024
(1) To maintain department approval, a health
				care entity modifying the scope, components or operation of an approved
				program, shall submit to the department:
(a)
				An application package specified in WAC 246-50030(1), modified as appropriate;
				and
(b) A detailed description of
				the modification and how it affects the program.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-040 - Alternative programs

Current through Register Vol. 24-14, July 15, 2024
A health care entity seeking department approval of an
				  alternative program shall submit to the department, in addition to the items
				  specified in WAC
				  246-50-030(1),
				  verification of certification or accreditation by an organization approved by
				  the department.
Statutory Authority:
					 RCW
					 43.70.510. 94-24-001, § 246-50-040,
					 filed 11/23/94, effective 12/24/94.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-050 - One-time mandatory renewal process

Current through Register Vol. 24-14, July 15, 2024
All health care entities with currently approved programs
				  must apply for renewal of their programs by December 31, 2021. An application
				  for renewal must meet the requirements of WAC
				  246-50-030(1).
				  A program remains approved while an application for renewal is under
				  consideration by the department. Failure to apply for renewal by December 31,
				  2021, will mean the approval is expired and no longer valid.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-060 - Public record disclosure

Current through Register Vol. 24-14, July 15, 2024
A program plan and all supplemental material are public
				  records and are subject to the Public Records Act, chapter 42.56 RCW, once the
				  department receives them. Health care entities submitting material they believe
				  is exempt from public record disclosure should clearly mark the portion or
				  portions as "exempt" and state the specific statutory basis for exemption. The
				  department will notify the health care entity of a public record disclosure
				  request for material the entity marked "exempt" in accordance with this
				  section. The department will allow the health care entity ten work days from
				  when it receives department notice to deliver to the department proof that the
				  entity has initiated formal action to secure an injunction under
				  RCW
				     42.56.540. Upon receiving such proof, the
				  department will notify the public record requester of the action the health
				  care entity initiated under
				  RCW
				     42.56.540, and take no further action pending
				  a decision by the court. The health care entity must notify the department if
				  it withdraws or takes any other action to terminate the judicial process under
				  RCW
				     42.56.540. Absent proof from the health care
				  entity that it has initiated action under
				  RCW
				     42.56.540, the department will disclose the
				  records consistent with state and federal law.
Statutory Authority:
					 RCW
					    43.70.510,
					 70.41.200,
					 4.24.250. 06-03-123, §
					 246-50-060, filed 1/18/06, effective
					 2/18/06.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-50 - Coordinated quality improvement program › Section 246-50-990 - Fees

Current through Register Vol. 24-14, July 15, 2024
A health care entity must submit a fee with each application
				  as follows:
Title of Fee
Fee
Original application
$250.00
Alternative application
40.00
Modification application of a department-approved
						  program
65.00
Renewal application
75.00
Statutory Authority:
					 RCW
					    43.70.510,
					 70.41.200,
					 4.24.250. 06-03-123, §
					 246-50-990, filed 1/18/06, effective 2/18/06. Statutory Authority:
					 RCW
					    43.70.510. 94-24-001, § 246-50-990,
					 filed 11/23/94, effective 12/24/94.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-70 - Marijuana product compliance › Section 246-70-010 - Findings

Current through Register Vol. 24-14, July 15, 2024
Anecdotal and limited scientific evidence indicates that the
				  use of marijuana may be beneficial to alleviate the symptoms of certain
				  physical and mental conditions. However, due to the current federal
				  classification of marijuana as a schedule 1 controlled substance, scientific
				  research has not been performed that would allow for standardized indications
				  of particular strains, which can vary radically in cannabinoid composition;
				  standard, reproducible formula or dosage; or accepted standards for drug
				  purity, potency and quality for the various conditions for which the medical
				  use of marijuana may be authorized. At this time, the decision of what
				  marijuana products may be beneficial is best made by patients in consultation
				  with their health care practitioners. For this reason, the department will not
				  limit the types of products available to qualifying patients. Instead, the
				  department intends to create standards for products that any consumer can rely
				  upon to be reasonably safe and meet quality assurance
				  measures.
Washington Administrative Code › Title 246 - Health, Department of › AGENCY DESCRIPTION › Chapter 246-70 - Marijuana product compliance › Section 246-70-020 - Applicability of WSLCB rules

Current through Register Vol. 24-14, July 15, 2024
The requirements in this chapter are in addition to all
				  WSLCB requirements in chapter 314-55 WAC. They are intended to build upon all
				  other requirements for licensed marijuana producers, processors and retailers,
				  and certified third-party labs.