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: March 9, 2020)

There are several regulatory issues at the top of WSHA’s priority list for March 2020:

  1. Pharmacy Quality Assurance Commission Rules Rewrite. The Pharmacy Quality Assurance Commission (PQAC) released its proposed rules under its multi-year Rule Rewrite Project. The proposed language moves all the rules pertaining to pharmacies into one new chapter, removes outdated provisions, and modernizes existing rules to address current practice.  In general, the proposed rules appear to strike a necessary balance between simplicity and clarity to ensure safe, effective care for patients utilizing pharmacists as integral members of the care team that they are today. WSHA advocated for several changes that are reflected in the current CR 102 language. These items include clarified licensing criteria; greater use of professional judgment by pharmacists; and advocating against changes that would lead to overly burdensome requirements for hospital pharmacies. We look forward to staying engaged and providing updates as this rulemaking progresses. (David Streeter)
  2. Clean Buildings Rulemaking. The Department of Commerce continues to hold a series of pre-rulemaking stakeholder sessions that will inform rulemaking in response to HB 1257, requiring all buildings over 50,000 square feet to comply with new energy use targets. The new law, passed in 2019, is aimed at decreasing greenhouse gas emissions among the building sector, which currently represent the second largest source of emissions in Washington state. Throughout the stakeholder meetings held this fall and winter, WSHA has been advocating for a methodology for setting the new energy use targets that considers the unique energy needs and building restrictions on hospitals. WSHA is currently leading an internal workgroup of hospital energy use leaders to continue assessing our position and feedback for the Department. If interested in joining this work group, please contact Lauren McDonald. (Lauren McDonald)
  3. Opioid Prescriptions: Patient Counseling and Right to Refuse. The Department of Health issued its final order regarding opioid prescriptions by physicians and physician assistants. The new rules require physicians and physician assistants to counsel patients on the risk of opioids and alternative treatments. The new rules also allow patients the right to refuse an opioid prescription, and for physicians to document this refusal in the patient’s medical record. The final order includes many exceptions to the patient opt-out that we believe protect patient safety in the case of emergency events or other scenarios where prescribing an opioid may not be avoidable. The rules were in response to legislation that passed in 2019 directing all boards and commissions overseeing opioid prescribers to adopt rules on these topics. (Lauren McDonald)
  4. Prescription Monitoring and Electronic Health Record Integration Waiver. The Department of Health issued a pre-proposal for developing a waiver program for the Prescription Monitoring Program and electronic health record integration mandated by SSB 5380. Facilities, entities, offices, or provider groups with 10 or more prescribers that face “economic hardship, technological limitations … or other exceptional circumstances” would be eligible to request a waiver from the health record integration requirement contained in RCW 70.225.090(2)(a). WSHA will continue to provide updates on this rulemaking process. (Lauren McDonald)
  5. Electronic Prescribing Mandate Waiver. As part of its implementation of the Electronic Prescribing Mandate created by SSB 5380, the Department of Health issued a pre-proposal for developing the required waiver for the program. According to the CR 101, prescribers who face “economic hardship, technological limitation, or other exceptional circumstance that prevents” compliance would be eligible to apply for a waiver. WSHA will continue to provide updates on this rulemaking process. (Lauren McDonald)
  6. Health Record Printing and Handling Fees. The Department of Health issued its required biennial proposal to increase the fees that health care providers may charge for handling and duplicating health records. Under the proposal, health care providers are permitted to charge up to $.24 per sheet for copies of health records up to 30 pages in length; and up to $.94 per sheet for all pages beyond 30. Health care providers would also be permitted to charge a clerical fee up to $28.00 for searching for health records. This proposal reflects the requirements contained in RCW 70.02.010(38). (David Streeter)

In addition to our ongoing Top Priority State Rules Track, we are including a running list of rulemaking completed in 2019 impacting hospitals and health systems. Each completed rules list contains our quick take of the result. Look for the thumbs up, thumbs down or neutral marker.

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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