Wash. Admin. Code ch. 284-170 – Health Benefit Plan Management | Midpage

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Washington Administrative Code (WAC)

Chapter 170

Wash. Admin. Code ch. 284-170

Health Benefit Plan Management

INSURANCE COMMISSIONER, OFFICE OF THE

284-170-110Purpose 284-170-120Applicability and scope 284-170-125Compliance with state and federal laws 284-170-130Definitions 284-170-131Definitions applicable to RCW 48.43.732 284-170-200Network access—General standards 284-170-205Behavioral health emergency services provider contracting 284-170-210Alternate access delivery request 284-170-220Amended alternate access delivery request for services subject to the Balance Billing Protection Act 284-170-230Maintenance of sufficient provider networks 284-170-240Use of subcontracted networks 284-170-260Provider directories 284-170-270Every category of health care providers 284-170-280Network reports—Format 284-170-285Mental health and substance use disorder web page model format and required content 284-170-300Essential community providers for exchange plans—Definition 284-170-310Essential community providers for exchange plans—Network access 284-170-320Issuer recordkeeping—Provider networks 284-170-330Tiered provider networks 284-170-340Assessment of access 284-170-350Issuer standards for women's right to directly access certain health care practitioners for women's health care services 284-170-360Enrollee's access to providers 284-170-365Continuity of care protections 284-170-370Hospital emergency service departments and practice groups 284-170-380Standards for temporary substitution of contracted network providers—"Locum tenens" providers 284-170-390Rule concerning contracted network providers called to active duty military service 284-170-401Provider and facility contracts with issuers—Generally 284-170-411Selection of participating providers—Credentialing and unfair discrimination 284-170-421Provider contracts—Standards—Hold harmless provisions 284-170-431Provider contracts—Terms and conditions of payment 284-170-433Provider contracts—Telemedicine 284-170-440Provider contracts—Dispute resolution process 284-170-441Public statements regarding contract terminations 284-170-443Provider contract terminations—Notice requirements—General standards 284-170-445Provider contract terminations under RCW 48.43.732—Notice requirements 284-170-447Enforcement—Public statements and notices regarding contract terminations 284-170-450Pharmacy identification cards 284-170-460Provider contracts—Audit guidelines 284-170-470Pharmacy claims—Rejections, notifications and disclosures 284-170-480Participating provider—Filing and approval 284-170-490Effective date