NoHLA Legislative Update #1 2017
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Northwest Health Law Advocates
Health Care Access in the Washington Legislature - Bills of Interest
Update #1 (February 27, 2017)
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Bill NameHouse Bill/ main sponsor Senate Bill/ main sponsorSummary DescriptionStatus
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PUBLIC PROGRAMS
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Health care for Pacific Islanders residing in WA under a compact of free associationSHB 1291 (Santos)Creates the COFA premium assistance program for enrollment in Qualified Health Plans in the WA Health Benefit Exchange.The program would pay premiums for persons from the compact of free association (COFA) islands (Palau, Marshall Islands, and Micronesia) who have income less than 133% of the federal poverty level. These persons generally do not qualify for Medicaid due to their specific immigration status. Bill is null and void unless funded in the budget.House Rules
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Notice of charity care availabilitySHB 1359 (Jinkins)Requires hospital billings to include a statement notifying patients that they may qualify for a discount regardless of whether they have insurance, and providing contact information. Notice must be provided in English and the most common non-English language spoken in the hospital service area.House Rules
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Oral health pilot program2SSB 5540 (Walsh)3-year pilot program ("oral health connections") to be developed jointly by WA Dental Foundation and HCA to test enhanced rates and additional periodontal services for pregnant women and adults with diabetes. This is modeled after the ABCD program that has provided better dental access to babies and children. Dental Foundation will do outreach and related services for the pilot. Annual report to legislature required.  Senate Rules
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Hearing instrument coverage2SSB 5179 BaileyRequires coverage for hearing instruments under public employee and Medicaid programs when "medically necessary," effective 1/1/18. Coverage must include a new hearing instrument every five years or when alterations to the existing device cannot meet the needs of the patient; also includes services and supplies. Bill is null and void unless funded in the budget.Senate Rules
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Requiring health plans to cover, with no cost sharing, all preventive services required to be covered under federal law as of 12/31/16SHB 1523 (Robinson)Requires health plans to provide coverage for the preventive services required under the Affordable Care Act as of 12/31/16, without cost-sharing.House
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State health insurance pool 2SHB 1338 Cody Extends the current sunset date of the Washington State Health Insurance Pool (WSHIP) for non-Medicare clients from December 31, 2017 to December 31, 2022.House Rules
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Limiting the authority to seek Medicaid waiversSB 5368 (Becker)Prohibits HCA from pursuing federal medicaid waivers that obligate the state to future spending, create entitlements, or expand the scope of government without legislative authorization.Senate Rules
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PRIVATE INSURANCE AND HEALTH BENEFIT EXCHANGE
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Protecting consumers from charges for out-of-network health servicesSHB 2114 (Cody)Prohibits "balance billing" for emergency services and certain other services provided at an in-network hospital, when the patient receives treatment from an out-of-network provider - one who does not have a contract with their health insurer. Emergency services is defined to include treatment for mental health and substance abuse disorder conditions. Non-emergency hospital services covered by the bill are limited to surgery, anesthesiology, pathology, radiology, laboratory, and hospitalist services; they must involve an "invasive medical procedure" as defined in the bill; and only in situations in which either (a) an in-network provider was unavailable; (b) the need for the services arose at the time the services were rendered and was unforeseen; or (c) the services were provided without the patient's consent. In situations covered by the bill, the patient may not be charged higher "out-of-network" copayments, coinsurance and deductibles; providers are limited to billing patients only at their insurer's in-network rates. A written explanation of benefits must be provided and various other consumer protections apply in the billing process. A dispute resolution process is available for providers and insurers to resolve payment in these situations. Provider and carrier websites must show providers' network participation. Detailed individual notices must be provided by both provider and carrier within 2 days of scheduling non-emergency hospital services covered by the bill, or 10 days before the date service is scheduled, regarding out-of-network status of their providers, insurance treatment of out-of-network costs, and other information. Penalties and remedies apply for violations.House Rules
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Fair dental insurance practicesSHB 1316 (Caldier)Requires carriers providing dental plans to have a utilization review program description and criteria based on prevention of dental disease and chronic disease implications,; they may not retrospectively deny coverage of services that were prior authorized at the time care was rendered, or subject providers to additional oversight solely because the provider, on behalf of a patient, files an appeal or grievance. This does not apply to fully capitated dental plans. OIC shall convene a workgroup to examine current carrier practices related to explanations of benefits sent to covered persons.House Rules
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PUBLIC HEALTH
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Foundational public health servicesSHB 1432 (Robinson)Creates a dedicated account to be used to fund population-based  "core or foundational" public health services, as defined in the bill, in every community. The Department of Health shall develop a public health improvement plan to accomplish this. Bill is null and void unless funded in the budget.House Rules
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HEALTH CARE PROVIDERS AND FACILITIES
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Dental health services in tribal settings
SSB 5079 (McCoy) Authorizes dental health aide therapist services provided by Indian tribes, tribal organizations, and urban Indian organizations to promote increased dental care access for persons served in these practice settings. Requires the state to seek federal Medicaid funding for these services.Passed, Governor signed
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Telemedicine locationsSB 5436 (Becker)Amends existing telemedicine statutes. Expands patient access to health services through telemedicine by further defining where a patient may receive the service as home or "any location determined by the individual receiving the service." Applies to Medicaid managed care plans, public employee (PEB) health plans, and other health plans in the state governed by RCW 48.43. Effective 2018.Passed Senate, in House Health
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Telemedicine payment paritySB 5457 (Becker)Amends existing telemedicine statutes to require that when telemedicine is covered, payment must be at the same rate as if the health care service was provided in person by the provider. An exception applies to "facility fees." Applies to Medicaid managed care plans, public employee (PEB) health plans, and other health plans in the state governed by RCW 48.43. Effective 2018.Senate
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Assistance with Activities of Daily Living in Assisted Living FacilitiesSHB 1671 (Cody)Amends RCW 18.20.310 so that the definition of Activities of Daily Living now includes Medication assistance, as defined in RCW 69.41.010.House Rules - suspension calendar
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HEALTH CARE OVERSIGHT & FINANCING
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Administration of the public employees' benefits programSSB 5653 (Becker)Transfers administration of the Public Employees Benefits Board from HCA to the Dept. of Retirement SystemsSenate Rules
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PATIENT HEALTH INFORMATION, PRIVACY AND CONSENT
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Providing women with timely information regarding their breast health.SSB 5084 (Rolfes)Requires information that identifies the patient's individual breast density classification to be included in the summary of mammography report provided to patients.Senate Rules
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Protecting nonpublic personal health information held by the OICSHB 1043 (Robinson)Nonpublic personal health information obtained by, disclosed to, or in the custody of the OIC is confidential and not subject to public disclosure. This information shall not be used by the OIC except in the course of regulatory or legal action as part of the commissioner's official duties.House Rules
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Expanding the scope of entities to whom mental health information and records may be disclosed without the patient's authorizationSHB 1413 (Cody)SSB 5435 (Rivers)Expands the authority to disclose mental health information without a patient's authorization to all health care providers when providing care to a patient. Allows the disclosure of mental health information to certain persons who requires it to assure coordinated care and treatment of a patient. Persons who may use or disclose the mental health information must take appropriate steps to protect it.House Rules; Senate Rules
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Expanding ability of the Department of Health to share prescription monitoring program data2SHB 1426 (Robinson)Expands the list of individuals and entities with whom the Department of Health may share data from the prescription monitoring program (PMP). Expands the permissible uses of this data. Extends immunity for accessing this data to include any person authorized to receive the data, instead of only dispensers and practitioners, and clarifies that this immunity protects against disciplinary actions, and not just legal actions; the scope of legal immunity conferred by the statute is expanded as well. By 1/21/2023, entities with access to PMP data that use electronic health records and that offer state-purchased care must integrate their electronic health records into the PMP. This law is null and void if funding is not appropriated for its implementation.House Rules
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Social Security medical recordsSHB 1239 (Sullivan)Requires health care facilities and providers to provide free copy of medical records to a patient or patient representative requesting them to appeal a denial of SSI or SSDI benefits.  House Rules
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REPRODUCTIVE HEALTH
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Addressing private health plan coverage of contraceptivesSHB 1234 (Robinson)SSB 5554 (Hobbs)Requires a health benefit plan that includes coverage for contraceptive drugs to provide reimbursement for a twelve-month refill of contraceptive drugs obtained at one time by the enrollee.House Rules; Senate Rules
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Requiring notification to parents or guardians in cases of abortionSB 5320 (Padden)Requires notice be provided to parent/guardian of pregnant women less than eighteen years of age 48 hours in advance of an abortion. Any person who performs and abortion upon a pregnant woman less than eighteen years of age without providing notice to parent/guardian, is guilty of a gross misdemeanor.Senate Rules
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Providing reasonable accommodations in the workplace for pregnant womenSHB 1796 (Farrell)Requires employers to provide reasonable work requirements for pregnancy-related conditions. Bill is null and void unless funded in the budget.House Rules
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Promoting healthy outcomes for pregnant women and familiesSSB 5835 (Keiser)Requires employers with 15 or more employees to provide reasonable accommodation for pregnancy unless the accommodation would impose an undue hardship on the employer's business. Requires certain health care facilities to establish maternal-newborn bonding practices. Establishes a task force focused on improving maternal and infant health.Senate Rules
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BEHAVIORAL HEALTH--MENTAL HEALTH AND SUBSTANCE USE DISORDERS
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Requiring health care disciplining authority to establish standards for prescription of opioids; and, requiring prescribers to complete continuing education on opioid prescription. SHB 1339 (Cody)Health care disciplining authorities must adopt rules governing opiod drug prescriptions consistent with Washington State interagency guideline. Prescribers must complete an hour of continuing education on opioid prescription best practices annually.House Rules
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Modernizing substance use disorder professional practice SHB 1340 (Cody)"Chemical dependency": professionals are now referred to as "substance use disorder" professionals. "Core competencies" of SUD professionals are no longer legally required to be oriented to assist patients achieve and maintain abstinence and develop individual support systems. SUD professionals may treat patients in settings other than SUD treatment programs.House Rules
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Addressing the requirements and oversight of opioid treatment programs. SHB 1427 (Cody)Shortens the list of factors that DSHS must consider in reviewing and deciding whether to grant an application for certification of an opioid treatment program. Counties and cities cannot require special use permits for citing opioid treatment programs. Removes general 350-patient limit for these programs, although counties may impose a patient limit at or above that level based on specific local conditions. Loosens program oversight and reporting requirements.House Rules
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Transferring designation and related powers and duties of behavioral health authority to HCASHB 1388 (Cody)Transfers responsibilities for the oversight and purchasing of behavioral health services from the Department of Social and Health Services (DSHS) to the Health Care Authority (HCA), except for the operation of the state hospitals. DSHS and HCA share authority over ITA'd minors ordered into less restrictive treatment. Adds psychiatric ARNPs as mental health professionals in children's mental health and crisis response laws and removes the requirement that they have two or three years experience treating MH conditions. Transfers responsibilities for the certification of behavioral health providers from the DSHS to the Department of Health. Adds certain MH provider types as those who may become designated crisis responders.House Rules
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Implementing recommendations from the children's mental health work group2SHB 1713 (Senn)Requires recommendations from children's mental health work group be implemented to address systemic barriers children and their families face to access necessary mental health services in order to improve mental health care access for children and their families through the early learning, K-12 education, and healthcare systems. Providers are encouraged to use behavioral health therapies and other therapies that are empirically supported or evidence-based and only prescribe medications for children and youth as a last resort.House Rules; Senate Ways & Means
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Concerning curricula for persons in long-term care facilities with behavioral health needsSHB 1548 (Schmick)Requires minimum competencies and standards be established for the approval of curricula for facility-based caregivers serving persons with behavioral health needs and geriatric behavioral health workers which includes at least thirty hours of training specific to the diagnosis, care, and crisis management of residents with a mental health disorder, traumatic brain injury, or dementia.House Rules
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Concerning behavioral health integration in primary careSSB 5779 (Brown)Defines “primary care behavioral health” as a health care integration model in which behavioral health care is colocated, collaborative, and integrated within a primary care setting. Requires review and adjustment to payment rules to facilitate integration of behavioral health in primary care settings by August 2017, including increased reimbursement to providers for behavioral health services provided to patients in primary care settings. Identifies outcomes upon which contract performance measures shall be developed.Senate Rules
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PRESCRIPTION DRUGS
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Addressing prescription drug cost transparency2SHB 1541 (Robinson)By March 1st of each year, issuers must provide prescription drug cost and utlization data, enrolleee spending data, and a summary analyis of the impacts of prescription drug costs to a data collection organization selected by the Office of Financial Management (OFM). Beginning 10/1/17, drug manufacturers that sell prescriptions drugs in Washington must give the data organization specific types of mostly financial data regarding drugs they sold for which there was a significant increase in price in the previous 1-3 years. The data organization shall  prepare an annual report summarizing the data. OFM may adopt rules and impose fines up to $1000/day for noncompliance. HCA will update the Legislature regarding value-based purchasing, prescription drug return on investment strategies, and recommendations for improving drug price and value transparency. This law is null and void if no specific funding is appropriated by June 30, 2017 to implement it.House Rules
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OTHER HEALTH CARE ACCESS RELATED BILLS
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Creating system for safe and secure collection and disposal of unwanted medicationsSHB 1047 (Peterson)Requires manufacturers that sell drugs in the state to create and operate a "take-back" program to collect and dispose of prescription and OTC drugs brought in by state residents (not businesses). Bill establishes detailed requirements for establishing and operating the program, serving as drug collector participants in the programs, and promoting the programs.House Rules
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Expanding ability of providers and debt collectors to charge prejudgement interest on and more easily prove a claim for an alleged medical debt.2SSB 5456 (Braun)Currently, entities owed a debt may assess prejudgement interest on the debt only when the debt is "liquidated" (meaning that the amount of the debut is specifically determinable.) This bill states that debts are "deemed" liquidated (even if they are not actually determinable or contested) at dates that vary slightly depending on the type of debt. Medical debts are deemed liquidated 120 days from the due date listed in a payment demand or when transferred to a debt collector. Debts for "medical or other professional services" even when rendered pursuant to a contract are considered "accounts receivable." This enables a party to initiate (and win) a legal action to collect the debt without having to prove that there was actually an initial agreement that gave rise to the asserted debt.Senate Rules
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Implementing family and medical leave insuranceSHB 1116 (Robinson)Provides benefits for individuals on leave for own or family member's serious health condition or for a military exigency, child's birth or placement. Allows 26 weeks of leave for birth/placement, family member's health condition, or military exigency (beginning 10/1/19); allows 12 weeks of leave for own serious health condition (beginning 10/1/20). Benefits based on individual's wages. Specifies a premium of 0.255% of wages, rising to .51% beginning 1/1/20 with subsequent annual adjustments, half deducted from employee wages.Startup funded by a loan to the Family & Medical Leave Insurance Account that must be repaid by the end of the biennium.House Rules
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Northwest Health Law Advocates | 206.325.6464 | nohla@nohla.org
February 27,2017
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