Washington Code|Chapter 48.43 - Insurance reform.

Section 48.43.001 - Intent.

Section 48.43.005 - Definitions.

Section 48.43.007 - Availability of price and quality information—Transparency tools for members—Requirements.

Section 48.43.008 - Enrollment in employer-sponsored health plan—Person eligible for medical assistance.

Section 48.43.009 - Health care sharing ministries.

Section 48.43.012 - Health plans—Preexisting conditions—Rules.

Section 48.43.01211 - Health plans—Eligibility—Health status-related factors—Rules.

Section 48.43.0122 - Individual health benefit plans—Open enrollment and special enrollment periods—Rules—Enforcement.

Section 48.43.0123 - Health plans—Rescission of coverage—Rules.

Section 48.43.0124 - Health plans—Cost sharing for essential health benefits—Rules.

Section 48.43.0125 - Essential health benefits—Annual or lifetime dollar limits.

Section 48.43.0126 - Summary of benefits and explanation of coverage—Standards and requirements—Notice of modification—Fines—Standards for definitions of health insurance terms—Rules.

Section 48.43.0127 - Group health plans—Waiting period—Rules.

Section 48.43.0128 - Nongrandfathered health plans and plans issued or renewed on or after January 1, 2022—Prohibited discrimination—Rules.

Section 48.43.016 - Utilization management standards and criteria—Health carrier requirements—Definitions.

Section 48.43.0161 - Prior authorization practices—Carrier annual reporting requirements—Commissioner's standardized report.

Section 48.43.021 - Personally identifiable health information—Restrictions on release.

Section 48.43.022 - Enrollee identification card—Social security number restriction.

Section 48.43.023 - Pharmacy identification cards—Rules.

Section 48.43.028 - Eligibility to purchase certain health benefit plans—Small employers and small groups.

Section 48.43.035 - Group health benefit plans—Guaranteed issue and continuity of coverage—Exceptions.

Section 48.43.038 - Individual health plans—Guarantee of continuity of coverage—Exceptions.

Section 48.43.039 - Grace period—Notification or information—Information concerning delinquencies or nonpayment of premiums—Defined.

Section 48.43.041 - Individual health benefit plans—Mandatory benefits.

Section 48.43.043 - Colorectal cancer examinations and laboratory tests—Required benefits or coverage.

Section 48.43.045 - Health plan requirements—Annual reports—Exemptions.

Section 48.43.047 - Health plans—Minimum coverage for preventative services—No cost-sharing requirements.

Section 48.43.049 - Health carrier data—Information from annual statement—Format prescribed by commissioner—Public availability.

Section 48.43.055 - Procedures for review and adjudication of health care provider complaints—Requirements.

Section 48.43.059 - Payments made by a second-party payment process—Definition.

Section 48.43.065 - Right of individuals to receive services—Right of providers, carriers, and facilities to refuse to participate in or pay for services for reason of conscience or religion—Requirements.

Section 48.43.071 - Health care information—Requirement to provide free copy to covered person appealing denial of social security benefits—Exceptions.

Section 48.43.072 - Required reproductive health care coverage—Restrictions on copayments, deductibles, and other form of cost sharing.

Section 48.43.073 - Required abortion coverage—Limitations.

Section 48.43.074 - Qualified health plans—Single invoice billing—Certification of compliance required in the segregation plan for premium amounts attributable to coverage of abortion services.

Section 48.43.078 - Digital breast tomosynthesis—Intent to ensure women with access—Commissioner's and health care authority's duty to clarify mandates.

Section 48.43.081 - Anatomic pathology services—Payment for services—Definitions.

Section 48.43.083 - Chiropractor services—Participating provider agreement—Health carrier reimbursement.

Section 48.43.085 - Health carrier may not prohibit its enrollees from contracting for services outside the health care plan.

Section 48.43.087 - Contracting for services at enrollee's expense—Mental health care practitioner—Conditions—Exception.

Section 48.43.091 - Health carrier coverage of outpatient mental health services—Requirements.

Section 48.43.093 - Health carrier coverage of emergency medical services—Requirements—Conditions.

Section 48.43.094 - Pharmacist provided services—Health plan requirements.

Section 48.43.096 - Medication synchronization policy required for health plans covering prescription drugs—Requirements—Definitions.

Section 48.43.097 - Filing of financial statements—Every health carrier.

Section 48.43.105 - Preparation of documents that compare health carriers—Immunity—Due diligence.

Section 48.43.115 - Maternity services—Intent—Definitions—Patient preference—Clinical sovereignty of provider—Notice to policyholders—Application.

Section 48.43.125 - Coverage at a long-term care facility following hospitalization—Definition.

Section 48.43.176 - Eosinophilic gastrointestinal associated disorder—Elemental formula.

Section 48.43.180 - Denturist services.

Section 48.43.185 - General anesthesia services for dental procedures.

Section 48.43.190 - Payment of chiropractic services—Parity.

Section 48.43.195 - Contraceptive drugs—Twelve-month refill coverage.

DISCLOSURE OF MATERIAL TRANSACTIONS

MISCELLANEOUS

RISK-BASED CAPITAL STANDARDS FOR HEALTH CARRIERS

PRESCRIPTION DRUG UTILIZATION MANAGEMENT

HEALTH CARE PATIENT PROTECTION

CONSTRUCTION