§ 43.371.070 — Rules.(Effective until July 1, 2026.)

Washington § 43.371.070

• Jurisdiction: Washington
• Title 43: STATE GOVERNMENT—EXECUTIVE
• Ch. 43.371: STATEWIDE HEALTH CARE CLAIMS DATA

Text

(1) The director shall adopt any rules necessary to implement this chapter, including:

(a) Definitions of claim and data files that data suppliers must submit to the database, including: Files for covered medical services, pharmacy claims, and dental claims; member eligibility and enrollment data; and provider data with necessary identifiers;

(b) Deadlines for submission of claim files;

(c) Penalties for failure to submit claim files as required;

(d) Procedures for ensuring that all data received from data suppliers are securely collected and stored in compliance with state and federal law;

(e) Procedures for ensuring compliance with state and federal privacy laws;

(f) Procedures for establishing appropriate fees;

(g) Procedures for data release;

(h) Penalties associated with the inappropriate disclosures or uses of direct patient identifiers, indirect patient identifiers, and proprietary financial information; and

(i) A minimum reporting threshold below which a data supplier is not required to submit data.

(2) The director may not adopt rules, policies, or procedures beyond the authority granted in this chapter.

Effective date — 2019 c 319: See note following RCW 43.371.020 .

Finding — 2014 c 223: See note following RCW 41.05.690 .

(1) The director shall adopt any rules necessary to implement this chapter, including:

(a) Definitions of claim and data files that data suppliers must submit to the database, including: Files for covered medical services, pharmacy claims, and dental claims; member eligibility and enrollment data; and provider data with necessary identifiers;

(b) Deadlines for submission of claim files;

(c) Penalties for failure to submit claim files as required;

(d) Procedures for ensuring that all data received from data suppliers are securely collected and stored in compliance with state and federal law;

(e) Procedures for ensuring compliance with state and federal privacy laws;

(f) Procedures for establishing appropriate fees;

(g) Procedures for data release;

(h) Penalties associated with the inappropriate disclosures or uses of direct patient identifiers and indirect patient identifiers; and

(i) A minimum reporting threshold below which a data supplier is not required to submit data.

(2) The director may not adopt rules, policies, or procedures beyond the authority granted in this chapter.

Effective date — 2025 c 305 ss 1 and 3-7: See note following RCW 43.371.010 .

Effective date — 2019 c 319: See note following RCW 43.371.020 .

Finding — 2014 c 223: See note following RCW 41.05.690 .

Legislative History

[2019 c 319 s 7;2015 c 246 s 7;2014 c 223 s 15.]