41.05.022 - State agent for purchasing health services--Single community-rated risk pool.

State agent for purchasing health services — Single community-rated risk pool.

(1) The health care authority is hereby designated as the single state agent for purchasing health services.

     (2) On and after January 1, 1995, at least the following state-purchased health services programs shall be merged into a single, community-rated risk pool: Health benefits for groups of employees of school districts and educational service districts that voluntarily purchase health benefits as provided in RCW 41.05.011; health benefits for state employees; health benefits for eligible retired or disabled school employees not eligible for parts A and B of medicare; and health benefits for eligible state retirees not eligible for parts A and B of medicare.

     (3) At a minimum, and regardless of other legislative enactments, the state health services purchasing agent shall:

     (a) Require that a public agency that provides subsidies for a substantial portion of services now covered under the basic health plan use uniform eligibility processes, insofar as may be possible, and ensure that multiple eligibility determinations are not required;

     (b) Require that a health care provider or a health care facility that receives funds from a public program provide care to state residents receiving a state subsidy who may wish to receive care from them, and that an insuring entity that receives funds from a public program accept enrollment from state residents receiving a state subsidy who may wish to enroll with them;

     (c) Strive to integrate purchasing for all publicly sponsored health services in order to maximize the cost control potential and promote the most efficient methods of financing and coordinating services;

     (d) Consult regularly with the governor, the legislature, and state agency directors whose operations are affected by the implementation of this section; and

     (e) Ensure the control of benefit costs under managed competition by adopting rules to prevent employers from entering into an agreement with employees or employee organizations when the agreement would result in increased utilization in public employees' benefits board plans or reduce the expected savings of managed competition.

[1995 1st sp.s. c 6 § 3; 1994 c 153 § 3; 1993 c 492 § 227.]

Notes: Effective date -- 1995 1st sp.s. c 6: See note following RCW 28A.400.410.

Intent -- Effective dates -- 1994 c 153: See notes following RCW 41.05.011.

Findings -- Intent--1993 c 492: See notes following RCW 43.20.050.

Short title--Severability -- Savings--Captions not law--Reservation of legislative power--Effective dates--1993 c 492: See RCW 43.72.910 through 43.72.915.