(1) Contractors must provide the authority with the following in the form and manner prescribed by the authority:

(a) Cost and quality of care information; and

(b) Data on all claims and encounters.

(2) Except for hospitals primarily engaged in the care and treatment of children in King and Pierce counties, providers and hospitals submitting any claims to a public employees' benefits board program and school employees' benefits board program health plan must include all the current year modifiers required by the Centers for Medicare and Medicaid Services. This ensures all rebates, incentives, or adjustments that would have applied if the services were reimbursed by medicare apply.

(3) Contractors may not enter into an agreement with a provider, hospital, or third party that would restrict the contractor from providing this information or data.

(4) If a contractor reimburses a hospital or provider on a nonfee-for-service basis or provides payment in addition to a fee-for-service arrangement, the contractor must report to the authority such alternative payment methods and amounts paid in a format determined by the authority, by no later than July 1st of each year for the preceding plan year.

(5) When the authority determines that a contractor failed to meet the requirements in this section, the authority provides the contractor with a written notice of noncompliance and assesses a fine for each failure according to WAC 182-40-1500.