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Current as of January 01, 2025 | Updated by Findlaw Staff
(1) The authority shall coordinate state agency efforts to develop and implement uniform policies across state purchased health care programs that will ensure prudent, cost-effective health services purchasing, maximize efficiencies in administration of state purchased health care programs, improve the quality of care provided through state purchased health care programs, and reduce administrative burdens on health care providers participating in state purchased health care programs. The policies adopted should be based, to the extent possible, upon the best available scientific and medical evidence and shall endeavor to address:
(a) Methods of formal assessment, such as a health technology assessment under RCW 70.14.080 through 70.14.130. Consideration of the best available scientific evidence does not preclude consideration of experimental or investigational treatment or services under a clinical investigation approved by an institutional review board;
(b) Monitoring of health outcomes, adverse events, quality, and cost-effectiveness of health services;
(c) Development of a common definition of medical necessity; and
(d) Exploration of common strategies for disease management and demand management programs, including asthma, diabetes, heart disease, and similar common chronic diseases. Strategies to be explored include individual asthma management plans.
(2) The director may invite health care provider organizations, carriers, other health care purchasers, and consumers to participate in efforts undertaken under this section.
(3) For the purposes of this section “best available scientific and medical evidence” means the best available clinical evidence derived from systematic research.
Cite this article: FindLaw.com - Washington Revised Code Title 41. Public Employment, Civil Service, and Pensions § 41.05.013. State purchased health care programs--Uniform policies - last updated January 01, 2025 | https://codes.findlaw.com/wa/title-41-public-employment-civil-service-and-pensions/wa-rev-code-41-05-013/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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