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LEGISLATIVE UPDATE: The 66th Legislature of Washington State is Underway


Legislative Session started on January 13, 2020, and for the first time in my lobbying career I had a bill pass on the third day of the legislative session. 2ESB 5887 “concerning health carrier requirements for prior authorization standards” passed the Senate with just one person voting no (Schoesler, R-9). You might be wondering how a bill passes so soon after the session started, so I will explain.


Lori Grassi, WSCA Legislative & External Affairs Director contracted entity


2. Defines six visits to each of the professions in the bill (rather than applying a total of six visits to all providers combined per episode of care)


3. Clarifies that the initial six visits cannot be contingent upon pre, post or concurrent review


4. May not retroactively deny care or refuse payment for the visits


5. Allows for action against fraud


The Washington Legislature is on a biennial cycle, with every other year a 60 day session, or a 105 day session. The longer sessions are on odd-numbered years and the short sessions are on even numbered years. The long session is intended to allow for a four year budget to be drafted and the shorter sessions are for supplemental budgets. This makes it harder for organizations like the WSCA to initiate funding for projects, or benefits, because the supplemental budget is intended to only “tweak” things, or react to court decisions. This also means that when a bill is introduced on an odd-numbered year, and it hasn’t passed, it goes to the “X” files. If the sponsor of the bill chooses to initiate further action on that bill from where it left off, rather than introducing a new bill, then they revert the bill to the last position in the process for final action. For us, ESB 5887 was in the Senate and rolled back to 2nd reading where it was amended to reflect the agreed upon language changes and passed. It is now in the House Health Care Committee where it will have to have a hearing and then pass to the full House for a vote.


Over the interim the provider coalition met with insurers to argue our case for requested language that would restore the provider-patient relationship when attempting to access benefits. The new language includes: 1. Applies to the carrier or its


10 www .chir ohealth.or g


SB 5601/HB 1562 Concerning Healthcare Benefit Management


This bill will require benefit managers, such as eviCore, Tivity, Optum, and American Specialty Health to have to register with the Office of the Insurance Commissioner. • Healthcare Benefit Managers are non- regulated entities and located outside of Washington State.


• Healthcare benefit managers are making clinical decisions over the top of WA state providers and are interrupting the provider-patient relationship.


• Healthcare benefit managers contract with more than one insurance carrier essentially giving them a deeper reach into the healthcare market.


eviCore affects the lives of more than 1.1 million covered lives as the benefit manager for Regence, Premera, and the Uniform Medical Plan. Tivity impacts the lives of more than 693,000 covered lives as the benefit manager for Kaiser Permanente and Aetna. Healthcare benefit managers are not regulated and have no transparency on their practices. When they can affect the care of so many people, they should be regulated by the Office of the Insurance Commissioner.


There have been multiple legislator- facilitated stakeholder meetings between


the provider coalition and the insurance companies who hire these benefit managers in an effort to discuss all of the impacts of the practices of these companies and to assure which of their practices should be captured in the legislation.


The House bill had a hearing in the House Health Care and Wellness committee on January 21, and the Senate hearing was in Senate Health and Long Term Care committee on January 27. You can watch those hearings at TVW.org by selecting “archives” and entering the date and committee name.


HB 2482/SB 6407 Concerning Spinal Manipulation Endorsement Requirements for Physical Therapists Four years ago the WSCA engaged in mediation with the Physical Therapy Association of Washington at the request of a legislator to attempt an agreement allowing physical therapists to manipulate the spine. The mediation did not yield an agreement, so the sponsoring legislator drafted a bill which forced an agreement. For a physical therapist to perform spinal manipulation they had to seek an endorsement through the Physical Therapy Licensing Board and show proof of additional hours of education in specific categories. The physical therapist that seeks the endorsement must attest to the training and a supervisor needs to sign the attestation form. As part of that agreement, there was a four-year time frame allowing the supervisor to be out-of-state, and that portion is set to expire June 30, 2020. In the four years that the endorsement has been in effect, the physical therapy association has entered into an interstate compact with 25 additional states. Because of this, the PTWA is seeking to allow the out-of-state supervisor language to remain in the statute rather than expire on


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