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284-180-110  <<  284-180-120 >>   284-180-130

(Effective until January 1, 2022)

PDFWAC 284-180-120

Applicability and scope.

This chapter applies to pharmacy benefit managers as defined in RCW 19.340.010.
(1) Specifically, this chapter applies to the actions of pharmacy benefit managers regarding contracts with pharmacies on behalf of an insurer, a third-party payor, or the prescription drug purchasing consortium established under RCW 70.14.060 in regard to:
(a) Fully insured health plans; and
(b) Medicaid plans. However, the appeal requirements of RCW 19.340.100 do not apply to medicaid plans.
(2) This chapter does not apply to the actions of pharmacy benefit managers acting as third-party administrators regarding contracts with pharmacies on behalf of an insurer, a third-party payor, or the prescription drug purchasing consortium established under RCW 70.14.060 in regard to:
(a) Self-insured health plans; and
(b) Medicare plans.
[Statutory Authority: RCW 48.02.060, 19.340.010, 19.340.030, 19.340.100, 19.340.110, and 2016 c 210 §§ 1 and 2 through 7. WSR 17-01-139 (Matter No. R 2016-07), § 284-180-120, filed 12/20/16, effective 1/1/17.]
(Effective January 1, 2022)

PDFWAC 284-180-120

Applicability and scope.

(1) This chapter applies to health care benefit managers as defined in RCW 48.200.020.
(2) This chapter does not apply to the actions of health care benefit managers providing services to, or acting on behalf of:
(a) Self-insured health plans;
(b) Medicare plans;
(c) Medicaid; and
(d) Union plans.
[Statutory Authority: RCW 48.02.060 and 48.200.900. WSR 21-02-034, § 284-180-120, filed 12/29/20, effective 1/1/22. Statutory Authority: RCW 48.02.060, 19.340.010, 19.340.030, 19.340.100, 19.340.110, and 2016 c 210 §§ 1 and 2 through 7. WSR 17-01-139 (Matter No. R 2016-07), § 284-180-120, filed 12/20/16, effective 1/1/17.]
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