Chapter 41.05 RCW

STATE HEALTH CARE AUTHORITY

Sections

HTMLPDF 41.05.004IntentUse of word "board."
HTMLPDF 41.05.006Purpose.
HTMLPDF 41.05.008Duties of employing agencies.
HTMLPDF 41.05.009Determination of public employee eligibility for benefits.
HTMLPDF 41.05.0091Eligibility exists prior to January 1, 2010.
HTMLPDF 41.05.011Definitions.
HTMLPDF 41.05.013State purchased health care programsUniform policies.
HTMLPDF 41.05.014Applications, enrollment forms, and eligibility certification documentsSignatures.
HTMLPDF 41.05.015Medical directorAppointment of personnel.
HTMLPDF 41.05.017Provisions applicable to health plans offered under this chapter.
HTMLPDF 41.05.018Transfer of certain behavioral health-related powers, duties, and functions from the department of social and health services.
HTMLPDF 41.05.021State health care authorityDirectorCost control and delivery strategiesHealth information technologyManaged competitionRules.
HTMLPDF 41.05.022State agent for purchasing health servicesSingle community-rated risk pool.
HTMLPDF 41.05.023Chronic care management programUniform medical planDefinitions.
HTMLPDF 41.05.026ContractsProprietary data, trade secrets, actuarial formulas, statistics, cost and utilization dataExemption from public inspectionExecutive sessions.
HTMLPDF 41.05.031Health information technology officeAgencies to establish health care information systems.
HTMLPDF 41.05.035Exchange of health informationAdvisory board, discretionaryDirector's authority.
HTMLPDF 41.05.036Health informationDefinitions.
HTMLPDF 41.05.037Nurse hotline, when funded.
HTMLPDF 41.05.039Health informationSecure accessLead organizationDirector's duties.
HTMLPDF 41.05.042Health informationProcesses, guidelines, and standards.
HTMLPDF 41.05.046Health informationConflict with federal requirements.
HTMLPDF 41.05.050Contributions for employees and dependents.
HTMLPDF 41.05.055Public employees' benefits boardMembers.
HTMLPDF 41.05.065Public employees' benefits boardDutiesEligibilityDefinitionsPenalties.
HTMLPDF 41.05.066Domestic partner benefits.
HTMLPDF 41.05.068Federal employer incentive programAuthority to participate.
HTMLPDF 41.05.074Public employeesPrior authorization standards and criteriaHealth plan requirementsDefinitions.
HTMLPDF 41.05.075Employee benefit plansContracts with insuring entitiesPerformance measuresFinancial incentivesHealth information technology.
HTMLPDF 41.05.080Participation in insurance plans and contractsRetired, disabled, or separated employeesCertain surviving spouses, state registered domestic partners, and dependent children.
HTMLPDF 41.05.083Employer groupsParticipation in insurance plans and contractsTermination of agreementPayment for retired or disabled employees.
HTMLPDF 41.05.085Retired state employee and retired or disabled school employee health insurance subsidy.
HTMLPDF 41.05.095Coverage for dependents under the age of twenty-six.
HTMLPDF 41.05.100Chapter not applicable to certain employees of Cooperative Extension Service.
HTMLPDF 41.05.120Public employees' and retirees' insurance accountSchool employees' insurance account.
HTMLPDF 41.05.123Flexible spending administrative accountSalary reduction accountSchool employees' benefits board flexible spending and dependent care administrative accountSchool employees' benefits board salary reduction account.
HTMLPDF 41.05.130State health care authority administrative accountSchool employees' insurance administrative account.
HTMLPDF 41.05.140Payment of claimsSelf-insuranceInsurance reserve fund created.
HTMLPDF 41.05.143Uniform medical plan benefits administration accountUniform dental plan benefits administration accountSchool employees' benefits board medical benefits administrative accountSchool employees' benefits board dental benefits administration account.
HTMLPDF 41.05.160Rules.
HTMLPDF 41.05.165RulesInsurance benefit reimbursement.
HTMLPDF 41.05.170Neurodevelopmental therapiesEmployer-sponsored group contracts.
HTMLPDF 41.05.175Prescribed, self-administered anticancer medication.
HTMLPDF 41.05.177Prostate cancer screeningRequired coverage.
HTMLPDF 41.05.180MammogramsInsurance coverage.
HTMLPDF 41.05.183General anesthesia services for dental proceduresPublic employee benefit plans.
HTMLPDF 41.05.185Diabetes benefitsState purchased health care.
HTMLPDF 41.05.188Eosinophilic gastrointestinal associated disorderElemental formula.
HTMLPDF 41.05.195Medicare supplemental insurance policies.
HTMLPDF 41.05.197Medicare supplemental insurance policies.
HTMLPDF 41.05.220Community and migrant health centersMaternity health care centersPeople of colorUnderserved populations.
HTMLPDF 41.05.225Blind licensees in the business enterprises programPlan of health insurance.
HTMLPDF 41.05.295Dependent care assistance programHealth care authorityPowers, duties, and functions.
HTMLPDF 41.05.300Salary reduction agreementsAuthorized.
HTMLPDF 41.05.310Salary reduction planPolicies and proceduresPlan document.
HTMLPDF 41.05.320Salary reduction planEligibilityParticipation, withdrawal.
HTMLPDF 41.05.330Salary reduction planAccounts and records.
HTMLPDF 41.05.340Salary reduction planTerminationAmendment.
HTMLPDF 41.05.350Salary reduction planRules.
HTMLPDF 41.05.360Salary reduction planConstruction.
HTMLPDF 41.05.400Plan of health care coverageAvailable fundsComponentsEligibilityDirector's duties.
HTMLPDF 41.05.405Public option plansAvailabilityHospital contractsRecommendations.
HTMLPDF 41.05.410Qualified health plansContract forRequirementsCost and quality data.
HTMLPDF 41.05.413Qualified health plansReimbursement limitWaiver.
HTMLPDF 41.05.430Plan of health care coverageImmediate postpartum contraception devices.
HTMLPDF 41.05.520Pharmacy connection programNotice.
HTMLPDF 41.05.525Treatment of opioid use disorderPrior authorization.
HTMLPDF 41.05.526Withdrawal management servicesSubstance use disorder treatment servicesPrior authorizationUtilization reviewMedical necessity review.
HTMLPDF 41.05.527Opioid overdose reversal medication bulk purchasing and distribution program.
HTMLPDF 41.05.528Standard set of criteriaMedical necessity for substance use disorder treatmentSubstance use disorder levels of careRules.
HTMLPDF 41.05.530Prescription drug assistance, educationRules.
HTMLPDF 41.05.533Medication synchronization policy required for health benefit plans covering prescription drugsRequirementsDefinitions.
HTMLPDF 41.05.540State employee health programRequirements.
HTMLPDF 41.05.550Prescription drug assistance foundationNonprofit and tax-exempt corporationDefinitionsLiability.
HTMLPDF 41.05.600Mental health servicesDefinitionCoverage required, when.
HTMLPDF 41.05.601Mental health servicesRules.
HTMLPDF 41.05.630Annual report of customer service complaints and appeals.
HTMLPDF 41.05.650Community health care collaborative grant programGrantsAdministrative supportEligibility.
HTMLPDF 41.05.651Rules2009 c 299.
HTMLPDF 41.05.660Community health care collaborative grant programAward and disbursement of grants.
HTMLPDF 41.05.670Chronic care management incentivesProvider reimbursement methods.
HTMLPDF 41.05.690Performance measures committeeMembershipSelection of performance measuresBenchmarks for purchasing decisionsPublic process for evaluation of measures.
HTMLPDF 41.05.700Reimbursement of health care services provided through telemedicine or store and forward technologyAudio-only telemedicine.
HTMLPDF 41.05.730Ground emergency medical transportation servicesMedicaid reimbursementCalculationFederal approvalDepartment's duties.
HTMLPDF 41.05.735Ground emergency medical transportation servicesMedicaid reimbursementIntergovernmental transfer programFederal approvalAuthority's duties.
HTMLPDF 41.05.740School employees' benefits board.
HTMLPDF 41.05.742Single enrollment requirement.
HTMLPDF 41.05.743School board membersEligibility for health benefits.
HTMLPDF 41.05.744School employee eligibility during COVID-19 state of emergency.
HTMLPDF 41.05.745School employees' benefits boardEmployee-paid, voluntary benefitsOptional benefits.
HTMLPDF 41.05.750Problem gambling and gambling disorder treatment program.
HTMLPDF 41.05.751Problem gambling account.
HTMLPDF 41.05.760Recovery residencesRegistry.
HTMLPDF 41.05.761Recovery residencesTechnical assistance for residences seeking certification.
HTMLPDF 41.05.762Recovery residencesRevolving fund.
HTMLPDF 41.05.810Prenatal substance exposure treatmentContracting.
HTMLPDF 41.05.820Qualified requirement for health carrier in insurance holding company to offer silver and gold health plans.
HTMLPDF 41.05.830Coverage for hearing instrumentsDefinitions.
HTMLPDF 41.05.831Coverage for hearing instruments.
HTMLPDF 41.05.840Universal health care commission.
HTMLPDF 41.05.845Prior authorization.
HTMLPDF 41.05.850Abortion coverageCost sharing.
HTMLPDF 41.05.890Certain health care and financial related data provided to authorityExempt from disclosure.
HTMLPDF 41.05.900Short title.
HTMLPDF 41.05.901ImplementationEffective dates1988 c 107.
HTMLPDF 41.05.950Retired or disabled public employeesSpecial health coverage enrollment opportunity.
HTMLPDF 41.05.951Retired or disabled employees of employer groupsReturn following termination of employer's agreement2023 c 312.

NOTES:

Hospitalization and health care for county, municipal and other political subdivision employees: RCW 41.04.180.
Monitoring enrollee level in basic health plan and medicaid caseload of childrenFunding levels adjustment: RCW 43.41.260.
Prepaid chiropractic, pilot projects: RCW 18.25.200.