State Regulatory Issues

State regulations have a big impact on hospitals, health systems and their patients. WSHA tracks rulemaking activity throughout the state and works closely with regulatory agencies, as well as other groups, to advocate for a reasonable regulatory environment. All statewide rulemaking activity is published in the Washington State Register.

Click here to see WSHA’s Top Priority State Rules Tracker

(Updated: June 24, 2020)

There are several regulatory issues at the top of WSHA’s priority list for April 2020, including several that are in response to COVID-19.

  1. COVID-19: Emergency Nursing Rules. The Nursing Quality Assurance Commission issued emergency rules to remove administrative barriers for nurses. The emergency rules are intended to enable more nurses to respond to the COVID-19 pandemic. (Alicia Eyler)
  1. Single Bed Certification. On June 5, the Health Care Authority (HCA) filed a new emergency order regarding single bed certification. This follows previous emergency orders HCA filed in February 2020 and November 2019. HCA’s permanent rulemaking stemming from the October 2019 CR-101 is still ongoing. June’s emergency order states HCA “completed the external review portion of the permanent rulemaking process, is currently reviewing the comments received as part of this review, and plans to file the proposed rules or a public hearing soon.” WSHA supports this rulemaking and submitted comments during HCA’s review process last month. WSHA will continue to provide updates as this rulemaking progresses. (Jaclyn Greenberg)
  1. Physician Assistants Ordering Home Health Services. The Department of Health issued emergency rules that add Physician Assistants to the list of medical practitioners eligible to order home health services. The emergency rules were issued in compliance with the federal CARES Act (H.R. 748), which requires this to become a permanent federal regulatory change. In addition, the HCA issued a pre-proposal to expand the list of non-physicians eligible to order home health services and supplies. WSHA supports this rulemaking and will monitor the process. (Alicia Eyler)
  1. Balanced Billing Protection Act. The Office of the Insurance Commissioner (OIC) issued a pre-proposal to begin a second round of rulemaking on the Balanced Billing Protection Act. This rulemaking is intended to provide greater clarity regarding the arbitration process and other questions that surfaced since the law became effective. WSHA will be commenting and will encourage OIC to adopt language supporting broad applicability for providers to aggregate similar claims with a carrier for arbitration purposes. (Andrew Busz)
  1. Pharmacy Rules Re-Write. The Pharmacy Quality Assurance Commission finalized its pharmacy rules re-write project. The new rules take effect July 1, 2020 and contain significant changes from the current rules. Please see this summary from the Commission and watch for a WSHA bulletin during the first week of July that contains details and next steps for hospitals. (David Streeter)
  1. Involuntary Patient Rights to Refuse Medication. The Health Care Authority issued a pre-proposal to develop rules regarding the right of involuntarily committed patients to refuse antipsychotic medication as required by RCW 71.05.215. WSHA will monitor this rulemaking and provide updates as further changes to the Involuntary Treatment Act (ITA) are implemented in accordance with SB 5720. Please see WSHA’s bulletin on key ITA changes for more information. Additional bulletins on ITA changes can be accessed on WSHA’s New Law Implementation Guide. (Jaclyn Greenberg)
  1. Clean Building Standards. The Department of Commerce is wrapping up its pre-rulemaking process for its new clean buildings standards. On June 18, the Department released its proposed energy use intensity targets for all building types, including hospitals. WSHA is a part of the stakeholder process and will submit comments on the energy use targets before the July 2 deadline. In late summer or early fall, the Department will issue its CR 102 proposal for the new clean building standards. (David Streeter)

Click here to see WSHA’s Top Priority State Rules Tracker – **2020 Completed Rules**

Click here to see WSHA’s Top Priority State Rules Tracker – **2019 Completed Rules**

Click here to see WSHA’s Top Priority State Rules Tracker – **2018 Completed Rules**


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