Legislative and Regulatory Summary, 2020

Legislative and Regulatory Outcomes from the 2020 Legislative Session

Thanks to the ARNPs United Legislative Committee, our hardworking chair, Louise Kaplan, and relentless lobbyist, Devon Connor-Green for their input and evaluation on the dozens of bills reviewed this session. Several bills that successfully passed both houses were recently vetoed by Governor Inslee to protect the budget and offset anticipated costs associated with COVID-19 expenses and loss of income, including a proposed rate increase on Medicaid reimbursement. Here are the session highlights:

HB  1433/SB 5647 The legislation promoted by ARNPs United requiring third party insurers to reimburse ARNPs equally for equal servicedid not get a hearing. House Health and Wellness Chair Eileen Cody, continues to oppose our bill, fearing an increase an insurance rates and citing physician’s longer education. ARNPs United planned an aggressive push over the summer to assure a hearing in the 2021 session, potentially with the Senate. However all plans are being reassessed as a consequence of social isolating. The Legislative Committee will meet in April to strategize a new plan.

SB 5385 requires parity reimbursement for visits performed via telehealth services compared to face-to-face services.

SB 6061 requires all but physicians to complete mandatory training of an unspecified length and content to perform telehealth visits. ARNPs United anticipates opposing and revising this in the coming legislative session.

SB 6087 limits out-of-pocket expenses for a 30-day supply of insulin to be capped at $100. The State Health Care Authority (HCA) is directed to monitor price of insulin.

SB 6492 eliminates the workforce education investment surcharge and replaces it with an increase to the Business and Occupation service rate from 1.5 to 1.75 percent. This will apply to businesses earning more than $1 million annually in the preceding calendar year. ARNPs United will monitor and work with other stakeholders in 2021 on revisions.

HB 2642 removes health coverage barriers to accessing Substance Use Disorder (SUD) treatment services

HB 1552 requires health carriers to reimburse a health care provider for covered health care services provided to the carrier's enrollees during the credentialing process under certain circumstances. Permits hospitals, rural health clinics, and rural providers to use substitute providers in certain circumstances. Requires Medicaid managed care organizations (MCOs) to reimburse substitute providers that provide services to MCO beneficiaries.

SB 6404 requires health plans to report to the Office of the Insurance Commissioner regarding services subject to prior authorization. The bill creates a prior authorization workgroup via the Health Care Authority or Bree Collaborative.

HB 2409 concerns Worker’s Compensation and includes a fine for ARNPs and other providers who fail to meet expected reporting requirements when caring for injured workers. ARNPs United was able to reduce the fine from $800 to $500.

The great news on Home Health Ordering:

• WA State Health Care Authority (HCA) as of April 3, 2020 changed administrative codes in accordance with the federal CARES Act (section 3708)to allow ARNPs and PAs to order home health services for Medicare. NO physician signature needed! 
• This public health emergency rule is temporary but permanent change is mandated to occur within 6 months of passage of the CARES Act.
• Find full text of WA State Emergency rule here: https://www.hca.wa.gov/assets/103E-20-09-016.pdf
• Find full text of CARES Act here: https://www.congress.gov/bill/116th-congress/house-bill/748/text  

Among the several bills that passed through both houses but vetoed by the governor because of the economic impact anticipated by the COVID-19 pandemic:

• SB 6128 Extending coverage during the postpartum period from 60 days to 12 months
• From the Supplemental operating budget the Early Childhood Education and Assistance Program (ECEAP) rate increase
• Reach out and Read funding  

Finally, on April 15 the Nursing Care Quality Assurance Commission voted to approve changes in ARNP license renewal to exclude a clinical practice requirement. ARNPs are advised to closely monitor the renewal requirements of their certifying body to confirm you are in compliance with national requirements.