WSHA Requests OIC Reconsider Health Care Benefit Manager Interpretation

November 17, 2021

WSHA has contacted and met with the state Office of the Insurance Commissioner (OIC) regarding an OIC legal interpretation that requires hospitals with delegated credentialing arrangements with insurers to register as health care benefit managers (HCBMs). WSHA provided OIC with an external legal analysis challenging the interpretation. OIC agreed to re-analyze the interpretation. WSHA will provide additional information to members once we receive a response on the outcome.

2SSB 5601, passed during the 2019 legislative session, requires certain entities that determine benefits and utilization of services on behalf of insurers to register as Health Care Benefit Managers (HCBM), but specifically excludes hospitals from the definition of HCBM. OIC staff had advised some insurers that hospitals that have a delegated credentialing arrangement with the insurer must register as HCBMs, and several hospitals have informed WSHA they are being pressured by insurers to do so. The deadline for HCBM registration is January 1, 2022. (Andrew Busz,


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