Finding, reading, and understanding the thousands of regulations that apply to health plans can drive a sane person to drink Flint, Michigan water. But not me. My sanity has already been questioned given that I intentionally spent a lot of money to go to school so I could learn the discipline of memorizing convoluted regulations late into the night.
Last week, I thought I had lost what little sanity remained when I looked up an insurance rule governing provider contracts and found everything scrambled. Then I looked some more and found blank pages where rules once lived. What’s going on?
In December, the Insurance Commissioner began shuffling the chapter of rules governing “Health Carriers and Health Plans” – Washington Administrative Code (WAC) Chapter 284-43. The existing Chapter rules were renumbered so that sub-chapter C of the rule – “WAC 284-43-300 Provider and facility contracts with issuers” – changed to “Sub-chapter Z Provider Contracts and Payment, WAC 284-43-9990.” So what?
Existing references in publications and communications with clients will need to be either updated or corrected. It happens all the time. But, there’s more.
A few weeks ago, the Insurance Commissioner decided to go a step further and move the provider contracting rules completely out of Chapter 284-43 to Chapter 284-170. The expedited rule making is not complete yet; so, if you go to WAC 284-170 entitled “Health Benefit Plan Management,” you will find absolutely nothing. That’s because all of the provisions of Chapter 284-170 were moved to Chapter 284-43 as sub-chapters B and C – the old references for health care networks and provider contracts.
Eventually we’ll all learn the new numbering scheme and I am sure it will be way better. In the meantime, don’t expect to go online and look for the old rules. They don’t live on the same block anymore.