41.05.660  <<  41.05.670 >>   41.05.680

Chronic care management incentivesProvider reimbursement methods.

(1) Effective January 1, 2013, the authority must contract with all of the public employees' benefits board managed care plans and the self-insured plan or plans to include provider reimbursement methods that incentivize chronic care management within health homes resulting in reduced emergency department and inpatient use.
(2) Health home services contracted for under this section may be prioritized to enrollees with complex, high cost, or multiple chronic conditions.
(3) For the purposes of this section, "chronic care management" and "health home" have the same meaning as in RCW 74.09.010.
(4) Contracts with fully insured plans and with any third-party administrator for the self-funded plan that include the items in subsection (1) of this section must be funded within the resources provided by employer funding rates provided for employee health benefits in the omnibus appropriations act.
(5) Nothing in this section shall require contracted third-party health plans administering the self-insured contract to expend resources to implement items in subsection (1) of this section beyond the resources provided by employer funding rates provided for employee health benefits in the omnibus appropriations act or from other sources in the absence of these provisions.
(6) The school employees' benefits board, under RCW 41.05.740, shall implement the provisions of this section, effective January 1, 2020.

NOTES:

Intent2017 3rd sp.s. c 13: See note following RCW 28A.150.410.
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