70.14.165  <<  70.14.170 >>   70.14.175

Opioid overdose reversal medicationsBulk purchasing and distributionRulesReportRecommendation to legislature.

(1) As soon as reasonably practicable, the health care authority shall establish a bulk purchasing and distribution program for opioid overdose reversal medication. The health care authority is authorized to:
(a) Purchase or enter into contracts as necessary to purchase and distribute opioid overdose reversal medication, collect an assessment, and administer the program;
(b) Bill, charge, and receive payment from health carriers, managed health care systems, and[,] to the extent that any self-insured health plans choose to participate, self-insured health plans; and
(c) Perform any other functions as may be necessary or proper to establish and administer the program.
(2) To establish and administer the opioid overdose reversal medication bulk purchasing and distribution program, the health care authority may adopt rules providing the following:
(a) A dosage-based assessment and formula to determine the assessment for each opioid overdose reversal medication provided to an individual through the program that includes administrative costs of the program;
(b) The mechanism, requirements, and timeline for health carriers, managed health care systems, and[,] self-insured plans to pay the dosage-based assessments;
(c) The types of health care facilities, health care providers, or other entities that are required to or are permitted to participate in the program;
(d) The billing procedures for any participating health care facility, health care provider, or other entity participating in the program; and
(e) Any other rules necessary to establish, implement, or administer the program.
(3) The following agencies, health plans, and insurers must participate in the bulk purchasing and distribution program:
(a) Health carriers;
(b) Managed health care systems administering a medicaid managed care plan; and
(c) The health care authority for purposes of:
(i) Health plans offered to public employees and their dependents;
(ii) Individuals enrolled in medical assistance under chapter 74.09 RCW that are not enrolled in a managed care plan; and
(iii) Uninsured individuals.
(4) The health care authority may establish an interest charge for late payment of any assessment under this section. The health care authority shall assess a civil penalty against any health carrier, managed health care system, or self-insured health plan that fails to pay an assessment within three months of billing. The civil penalty under this subsection is 150 percent of such assessment. The health care authority is authorized to file liens and seek judgment to recover amounts in arrears and civil penalties, and recover reasonable collection costs, including reasonable attorneys' fees and costs. Civil penalties so levied must be deposited in the opioid overdose reversal medication account created in RCW 70.14.175.
(5) The health care authority in coordination with the office of the insurance commissioner may recommend to the appropriate committees of the legislature the termination of the bulk purchasing and distribution mechanism for opioid overdose reversal medication if it finds that the original intent of its formation and operation has not been achieved.
(6) By January 1, 2022, the health care authority shall submit a report to the legislature on the progress towards establishing the bulk purchasing and distribution program. The health care authority shall submit an updated report on the progress towards establishing the bulk purchasing and distribution program by January 1, 2023.
(7) By July 1, 2025, the health care authority shall submit recommendations to the appropriate committees of the legislature on whether and how the opioid overdose reversal medication bulk purchasing and distribution program may be expanded to include other prescription drugs.
(8) "Opioid overdose reversal medication" has the same meaning as provided in RCW 69.41.095.

NOTES:

Rules2021 c 273 §§ 7-12: "(1) The health care authority may adopt rules necessary to implement sections 7 through 12 of this act.
(2) The insurance commissioner may adopt rules necessary to implement sections 7 and 11 of this act." [ 2021 c 273 § 13.]
FindingsIntent2021 c 273: See note following RCW 70.41.480.
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