Rules Under Development

Medical Aid Rules

Chapter 296-20, WAC

All updates for this rule:

Medical Aid Rules

This rule updates conversion factors provided in WAC 296-20-135 and maximum daily fees provided in WAC 296-23-220 and WAC 296-23-230 for certain professional health care services for injured workers. Rule changes are necessary to maintain current overall fees for health care services, which are published annually in the Medical Aid Rules and Fee Schedules.696.

4/22/2014

PDF: Adoption (Rule-Making Order CR-103)

PDF: Adopted Rule Language

4/1/2014

Comments Due

3/25/2014

Public Hearing

2/19/2014

PDF: Proposed Rulemaking (CR 102)

PDF: Proposed Rule Language

12/17/2013

PDF: Preproposal (CR-101)

Emergency Rule - Medical Provider Network (Provider Application Process)

Substitute Senate Bill 5801 (Chapter 6, Laws of 2011) amended RCW 51.36.010 to direct L&I to establish a statewide medical provider network for treating injured and ill workers. L&I adopted rules in 2012 so that, starting January 1, 2013, only network providers may treat injured workers beyond an initial visit. WAC 296-20-01020 allows providers to be provisionally enrolled while L&I decides on their application, but only for 60 days. The emergency rule allows providers who applied prior to January 1, 2013, to continue to treat injured workers until their application is approved, denied, or withdrawn; and it removes the 60-day limit on provisional enrollment until expiration of the emergency rule or until L&I takes further action to change the rule, whichever is first. The changes were adopted 3/1/2013 and became effective on 3/1/2013.677.

3/1/2013

PDF: Emergency Order Adoption (CR 103)

PDF: Adopted Rule Language

3/1/2013

Rule Changes Effective

Drug Rules

This rule is being adopted to ensure safe, appropriate and effective drug therapy designed to improve clinical outcomes and support successful return to work. The adopted rule language updates the coverage of and payment for prescription drugs and describes specific authorization requirements for the payment of opioids. Authorization requirements are based on best practices for prescribing opioids and will lead to safe and effective treatment for injured and ill workers. The changes were adopted 5/28/2013 and became effective on 7/1/2013.675.

7/1/2013

Rule Changes Effective

5/28/2013

PDF: Adoption (Rule-Making Order CR-103)

PDF: Adopted Rule Language

4/26/2013

Comments Due

4/23/2013

Public Hearing

3/19/2013

PDF: Proposed Rulemaking (CR 102)

PDF: Proposed Rule Language

1/2/2013

PDF: Preproposal (CR-101)

Medical Aid Conversion Factors, Physical Therapy Rules, and Occupational Therapy Rules

This rule adoption updates L&Is payment rates for health care services, which are published annually in the Medical Aid Rules and Fee Schedules. L&I is updating the anesthesia conversion factor that is used to determine the rates for most anesthesia services from $3.22 to $3.25, and updating the physical therapy (PT) and occupational therapy (OT) maximum daily payment level (PT/OT cap) from $119.01 to $119.96. The changes were adopted 5/7/2013 and became effective on 7/1/2013.672.

7/1/2013

Rule Changes Effective

5/7/2013

PDF: Adoption (Rule-Making Order CR-103)

PDF: Adopted Rule Language

4/16/2013

Comments Due

4/10/2013

Public Hearing

3/5/2013

PDF: Proposed Rulemaking (CR 102)

PDF: Proposed Rule Language

12/18/2012

PDF: Preproposal (CR-101)

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