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PDFWAC 182-400-0200


For the purposes of this chapter:
"Authority" means the Washington state health care authority.
"Carrier" is defined in RCW 48.43.005.
"Health benefit exchange" means the Washington state health benefit exchange established in RCW 43.71.020.
"Hospital" means any hospital licensed under chapter 70.41 RCW that receives payment for services provided:
(a) To enrollees in the public employees benefits program or school employees benefits program under chapter 41.05 RCW; or
(b) Through a medical assistance program under chapter 74.09 RCW.
"Parties" means carriers and hospitals as defined in this chapter.
"Plan year" means the 12-month period beginning on January 1st of each year and ending on December 31st of the same year.
"Public option plan" means a qualified health plan contracted by or offered in a response to a procurement issued by the authority under RCW 41.05.410.
"Valid offer to contract" means:
(a) A written offer made by a carrier to a hospital to enter into a contract with the carrier to provide in-network coverage to enrollees of the carrier's public option plans; and
(b) The carrier's offer must contain sufficient information so that a reasonable person would understand that a good faith offer has been made. The carrier must, at a minimum, include the reimbursement rate offered in a manner that constitutes a legally binding document that the parties could execute.
[Statutory Authority: RCW 41.05.021, 41.05.160 and 2021 c 246. WSR 22-10-023, ยง 182-400-0200, filed 4/25/22, effective 6/1/22.]
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