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182-40-1000  <<  182-40-1100 >>   182-40-1200

(Effective January 1, 2027)

PDFWAC 182-40-1100

Contractor responsibility for ensuring reimbursement to providers and provider networks.

Contractors are responsible for ensuring any reimbursements to providers and provider networks comply with reimbursement requirements established in WAC 182-40-0300 and 182-40-0400. This includes provider reimbursements resulting from arrangements with any person or organization the contractor uses to develop its provider network. For example, arrangements include, but are not limited to, rental provider networks, subcontracted business partners, subcontracted provider networks, contracted vendor networks, reciprocal claims pricing arrangements, health care benefit managers as defined in RCW 48.200.020, etc.
[Statutory Authority: RCW 41.05.021, 41.05.160, and 41.05.028. WSR 25-24-066, s 182-40-1100, filed 12/1/25, effective 1/1/27.]