In June, the Washington Insurance Commissioner adopted new rules creating uniform standards for health plan procedures for prior authorization of health care services. The new rules take effect for health plans and stand-alone dental and vision plans issued or renewed after January 1, 2018 with rules governing online prior authorization taking effect November 1, 2019.…
Regulators never take a holiday, especially in December when giving seems so right. Washington D.C. and Washington State have given new gifts to unwrap throughout the coming year. On December 16th, the Center for Consumer Information and Insurance Oversight (CCIIO), a subsidiary of the conglomerate Centers for Medicare & Medicaid Services of the United Stated…
I’ve always admired the modesty of regulatory agencies and their polite expression of force. You might be pleased to learn that the Department of Labor (DOL) just issued interim final rules “to adjust the amounts of civil penalties assessed or enforced in its regulations.” Of course, if you understand official language, you know that the…
This past legislative session, the Washington House of Representatives considered regulation of third party administrators (TPAs) as recommended by the state Insurance Commissioner. After some confusion over what the Commissioner intended and what should be amended, the bill died a quiet death in committee. Policymakers quickly discovered that TPA regulation had become a surrogate for indirectly addressing…
Words matter. The meaning and use of words matter even more. That’s why discrimination can be a great thing – if you’re talking about insurance. Why? For one reason, folks who are careless should pay more for insurance than folks who are careful. Insurers don’t care why folks are careless; insurers want to be “discriminatory”…
The Washington Insurance Commissioner has requested legislation for registration of third party administrators to protect consumers. Third party administrators (TPAs) come in all shapes and sizes and just as many flavors. Insurers typically provide most services for administration of its own health plans. Many Insurers also sell administrative services to self-funded plans which would make…
